MEDICARE: KLEIN DENTAL - STALEY

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

General Provider Information

NPI Number	:	1801755574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLEIN DENTAL - STALEY

Provider Business Mailing Address
First Line	:	506 NE 107TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-1574
Country	:	US
Telephone Number	:	816-605-0034
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 NE 107TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-1574
Country	:	US
Telephone Number	:	816-605-0034
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	SCOT KESSLER
Credential	:
Telephone Number	:	816-605-0034

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “KLEIN DENTAL - STALEY ” Practice Location

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