Healthcare Provider Details

I. General information

NPI: 1619167418
Provider Name (Legal Business Name): APARNA NAIDU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9705 LENEXA DR
LENEXA KS
66215-1345
US

IV. Provider business mailing address

9705 LENEXA DR
LENEXA KS
66215-1345
US

V. Phone/Fax

Practice location:
  • Phone: 913-396-8509
  • Fax: 913-495-9743
Mailing address:
  • Phone: 913-396-8509
  • Fax: 913-495-9743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number2017044375
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number2017044375
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: