Healthcare Provider Details

I. General information

NPI: 1265479885
Provider Name (Legal Business Name): DONNA N DEINES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E 63RD ST
KANSAS CITY MO
64113-2224
US

IV. Provider business mailing address

203 E 63RD ST
KANSAS CITY MO
64113-2224
US

V. Phone/Fax

Practice location:
  • Phone: 816-333-8400
  • Fax: 816-361-2598
Mailing address:
  • Phone: 816-333-8400
  • Fax: 816-361-2598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number013178
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: