Healthcare Provider Details

I. General information

NPI: 1831054204
Provider Name (Legal Business Name): SAFDER OLATHE ENDODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20168 W 153RD ST
OLATHE KS
66062-9131
US

IV. Provider business mailing address

20168 W 153RD ST
OLATHE KS
66062-9131
US

V. Phone/Fax

Practice location:
  • Phone: 913-396-7625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: MANSOOR SAFDER
Title or Position: OWNER DENTIST
Credential: DDS, MSD
Phone: 913-206-2758