Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Randal Duane Otis, DMD

Individual provider General Practice Dentistry · NPI 1629683925

Dr. Randal Duane Otis, DMD is a General Practice Dentistry in Kansas City, Missouri. Practices as a sole proprietor and works from 2 locations. Licensed in Georgia and Missouri.

Licensed in
GA, MO
In the registry since
2020
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

650 E 25th St
Kansas City, MO 64108-2716
Phone: (816) 235-2177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 938 W Church St, Jasper, GA 30143-1496 — (706) 862-1769

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 2021010442 (MO)
General Practice Dentistry Taxonomy 1223G0001X · Licence DN016113 (GA)

Record details

NPI number1629683925
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedSeptember 14, 2020
Last updated in NPPESJune 15, 2021
Certification dateJune 15, 2021

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