Healthcare Provider Details

I. General information

NPI: 1134805583
Provider Name (Legal Business Name): NATHAN ROMME DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 DOWNING AVE
HAYS KS
67601-2461
US

IV. Provider business mailing address

4105 TRUMAN CIR
HAYS KS
67601-4715
US

V. Phone/Fax

Practice location:
  • Phone: 785-625-6001
  • Fax:
Mailing address:
  • Phone: 785-639-2906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number62111
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2023021848
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: