Healthcare Provider Details

I. General information

NPI: 1225976723
Provider Name (Legal Business Name): JAMES DIXON DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6336 N LUCERNE AVE
KANSAS CITY MO
64151-3199
US

IV. Provider business mailing address

6921 NE 70TH ST
KANSAS CITY MO
64119-5604
US

V. Phone/Fax

Practice location:
  • Phone: 806-830-2999
  • Fax:
Mailing address:
  • Phone: 816-830-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES BOHANNON DIXON
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 816-830-2999