Healthcare Provider Details

I. General information

NPI: 1679407860
Provider Name (Legal Business Name): ANDREW FIAUSH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8568 N CHURCH RD
KANSAS CITY MO
64157-1202
US

IV. Provider business mailing address

8568 CHURCH RD
KANSAS CITY MO
64157-1202
US

V. Phone/Fax

Practice location:
  • Phone: 816-579-0426
  • Fax:
Mailing address:
  • Phone: 816-579-0426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026025426
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: