MEDICARE: MICHAEL SILVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	61375	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1992956486	OTHER	KS	DR. DOUGLAS J SJOGREN
2	1992956486	OTHER	KS	SHOW YOUR GRIN DENTAL

General Provider Information

NPI Number	:	1063906907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SILVA

Provider Business Mailing Address
First Line	:	13772 S BLACKBOB RD
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1932
Country	:	US
Telephone Number	:	913-469-8019
Fax Number	:

Provider Business Practice Location Address
First Line	:	13772 S BLACKBOB RD
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1932
Country	:	US
Telephone Number	:	913-469-8019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2018
Last Update Date	:	06/14/2018

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Directions to “ MICHAEL SILVA ” Practice Location

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