Healthcare Provider Details

I. General information

NPI: 1013823715
Provider Name (Legal Business Name): ANCHOR DENTAL & IMPLANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6571 SILVERHEEL ST
SHAWNEE KS
66226
US

IV. Provider business mailing address

12475 S SHADY BEND RD
OLATHE KS
66061-5211
US

V. Phone/Fax

Practice location:
  • Phone: 801-628-5603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY JON JEPPERSON
Title or Position: OWNER
Credential: DDS
Phone: 801-628-5603