Healthcare Provider Details

I. General information

NPI: 1104508423
Provider Name (Legal Business Name): BRADEN LESHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 DELAWARE ST
KANSAS CITY MO
64105-1215
US

IV. Provider business mailing address

317 DELAWARE ST
KANSAS CITY MO
64105-1215
US

V. Phone/Fax

Practice location:
  • Phone: 816-867-4148
  • Fax:
Mailing address:
  • Phone: 816-867-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number109059
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: