Healthcare Provider Details

I. General information

NPI: 1730203902
Provider Name (Legal Business Name): REBECA WEISLEDER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E 25TH ST
KANSAS CITY MO
64108-2716
US

IV. Provider business mailing address

650 E 25TH ST
KANSAS CITY MO
64108-2784
US

V. Phone/Fax

Practice location:
  • Phone: 816-235-2039
  • Fax:
Mailing address:
  • Phone: 816-235-2039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0058
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number26573
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2024041155
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: