Healthcare Provider Details

I. General information

NPI: 1033671664
Provider Name (Legal Business Name): MEGAN PERRIMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 05/29/2023
Certification Date: 05/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 MAIN ST
PARKVILLE MO
64152-3737
US

IV. Provider business mailing address

407 MAIN ST
PARKVILLE MO
64152-3737
US

V. Phone/Fax

Practice location:
  • Phone: 816-505-9445
  • Fax:
Mailing address:
  • Phone: 816-505-9445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2018017548
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: