Organization
JAMES B INDIVERI DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES B INDIVERI DMD PC (PRESIDENT)
(816) 229-1245
Entity
Organization
Contact information
Practice address
300 NW R D MIZE ROAD, BLUE SPRINGS, MO 64014
(816) 229-1245
(816) 229-7555
Mailing address
300 NW R D MIZE ROAD, BLUE SPRINGS, MO 64014
(816) 229-1245
(816) 229-7555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
015196
MO
122300000X
Dentist
Primary
6441
KS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
445
KS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
810
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113498
UNITED CONCORDIA
—
01
—
13670041
BLUE CROSS BLUE SHIELD OF
MO
01
—
275737
BLUE CROSS BLUE SHIELD TR
—
01
—
619312
BLUE CROSS BLUE SHIELD KS
KS
Enumeration date
11/07/2006
Last updated
09/11/2025
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