Healthcare Provider Details

I. General information

NPI: 1316684137
Provider Name (Legal Business Name): CHRISTOPHER WILLIAM HEYE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/13/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12208 W 87TH STREET PKWY STE 160
LENEXA KS
66215-2896
US

IV. Provider business mailing address

4111 BROADWAY UNIT 310
KANSAS CITY MO
64111-3354
US

V. Phone/Fax

Practice location:
  • Phone: 913-888-0403
  • Fax:
Mailing address:
  • Phone: 501-772-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number61845
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: