Healthcare Provider Details

I. General information

NPI: 1013003284
Provider Name (Legal Business Name): SUE E HIGGINS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE E JOHNSON HIGGINS DDS

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 W CULTON ST
WARRENSBURG MO
64093-1720
US

IV. Provider business mailing address

PO BOX 184
CENTERVIEW MO
64019-0184
US

V. Phone/Fax

Practice location:
  • Phone: 816-810-4567
  • Fax: --
Mailing address:
  • Phone: 816-810-4567
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN014179
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: