Healthcare Provider Details

I. General information

NPI: 1376488064
Provider Name (Legal Business Name): MIDWEST DENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 W 93RD ST STE 140
OVERLAND PARK KS
66212-1465
US

IV. Provider business mailing address

6750 W 93RD ST STE 110
OVERLAND PARK KS
66212-1465
US

V. Phone/Fax

Practice location:
  • Phone: 913-276-3809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: WAYNE DOBBINS
Title or Position: OWNER
Credential:
Phone: 913-276-3809