Healthcare Provider Details

I. General information

NPI: 1811980469
Provider Name (Legal Business Name): COOKSON & HANSEN, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 N OAK TRFY SUITE 101
KANSAS CITY MO
64118-4705
US

IV. Provider business mailing address

6301 N OAK TRFY SUITE 101
KANSAS CITY MO
64118-4705
US

V. Phone/Fax

Practice location:
  • Phone: 816-452-0300
  • Fax: 816-452-3385
Mailing address:
  • Phone: 816-452-0300
  • Fax: 816-452-3385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: CINDY WALDMAN
Title or Position: OFFICE MRG
Credential:
Phone: 816-452-0300