MEDICARE: COOKSON & HANSEN, DDS, PC

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	L370000	OTHER	MO	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22814021	OTHER	MO	BCBS

General Provider Information

NPI Number	:	1811980469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOKSON & HANSEN, DDS, PC

Provider Business Mailing Address
First Line	:	6301 N OAK TRFY
Second Line	:	SUITE 101
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4705
Country	:	US
Telephone Number	:	816-452-0300
Fax Number	:	816-452-3385

Provider Business Practice Location Address
First Line	:	6301 N OAK TRFY
Second Line	:	SUITE 101
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4705
Country	:	US
Telephone Number	:	816-452-0300
Fax Number	:	816-452-3385

Authorized Official
Title or Position	:	OFFICE MRG
Name	:	CINDY WALDMAN
Credential	:
Telephone Number	:	816-452-0300

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	11/06/2007

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Directions to “COOKSON & HANSEN, DDS, PC ” Practice Location

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