Healthcare Provider Details

I. General information

NPI: 1750311965
Provider Name (Legal Business Name): ANN ADAMS FAY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 LONG ST SUITE 201
SHAWNEE KS
66216-2559
US

IV. Provider business mailing address

6333 LONG ST SUITE 201
SHAWNEE KS
66216-2559
US

V. Phone/Fax

Practice location:
  • Phone: 913-268-9300
  • Fax: 913-268-4202
Mailing address:
  • Phone: 913-268-9300
  • Fax: 913-268-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number60179
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: