Healthcare Provider Details

I. General information

NPI: 1841029113
Provider Name (Legal Business Name): JORDAN KANE THOMPSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JORDAN MICHELLE KANE DDS

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 N 2ND ST
ATCHISON KS
66002-1203
US

IV. Provider business mailing address

4601 NE 85TH TER
KANSAS CITY MO
64156-1264
US

V. Phone/Fax

Practice location:
  • Phone: 913-367-4879
  • Fax:
Mailing address:
  • Phone: 573-842-0483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number62355
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2024029600
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: