Healthcare Provider Details

I. General information

NPI: 1295868388
Provider Name (Legal Business Name): KEVIN J. STERLING DDSPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 E KANSAS AVE
GARDEN CITY KS
67846-5806
US

IV. Provider business mailing address

1402 E KANSAS AVE
GARDEN CITY KS
67846-5806
US

V. Phone/Fax

Practice location:
  • Phone: 620-275-4251
  • Fax: 620-275-5389
Mailing address:
  • Phone: 620-275-4251
  • Fax: 620-275-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5450
License Number StateKS

VIII. Authorized Official

Name: DR. KEVIN JAMES STERLING
Title or Position: PRESIDENT
Credential: DDS
Phone: 620-275-4251