MEDICARE: KAYLA BURK

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	124Q00000X	Dental Hygienist	2025014711	MO

General Provider Information

NPI Number	:	1114715976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA BURK

Provider Business Mailing Address
First Line	:	4401 W 107TH ST APT 103
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66207-4118
Country	:	US
Telephone Number	:	620-802-1249
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 E NORTH AVE
Second Line	:
City	:	BELTON
State	:	MO
Zip	:	64012-2013
Country	:	US
Telephone Number	:	816-599-5170
Fax Number	:

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

Provider Enumeration Date	:	04/30/2025
Last Update Date	:	04/30/2025

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Directions to “ KAYLA BURK ” Practice Location

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