Healthcare Provider Details

I. General information

NPI: 1093534364
Provider Name (Legal Business Name): SHONTE DIONNE REED DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/04/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 LEES SUMMIT RD
KANSAS CITY MO
64139-1236
US

IV. Provider business mailing address

14004 DUNOON ST
GRANDVIEW MO
64030-4048
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-6885
  • Fax:
Mailing address:
  • Phone: 417-838-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2024040240
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: