Healthcare Provider Details

I. General information

NPI: 1396661229
Provider Name (Legal Business Name): CADEN TILLETT OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13839 S MUR LEN RD
OLATHE KS
66062-1685
US

IV. Provider business mailing address

11505 RILEY ST
OVERLAND PARK KS
66210-2246
US

V. Phone/Fax

Practice location:
  • Phone: 913-782-5993
  • Fax:
Mailing address:
  • Phone: 270-994-8682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: