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

Dr. Ted A Deatherage, DMD

Individual provider Dentist · NPI 1689721813

Dr. Ted A Deatherage, DMD is a Dentist in West Plains, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2007
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

1616 Gibson St
West Plains, MO 65775-1814
Phone: (417) 257-0126
Fax: (417) 256-2469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DEA015659 (MO)

Record details

NPI number1689721813
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedJanuary 3, 2007
Last updated in NPPESJuly 8, 2007
Mailing address1616 Gibson St, West Plains, MO 65775-1814

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