Healthcare Provider Details

I. General information

NPI: 1689519431
Provider Name (Legal Business Name): SWEET TOOTH BLUE SPRING'S ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 NW HWY 7
BLUE SPRINGS MO
64015
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: 913-276-3809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

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