Healthcare Provider Details

I. General information

NPI: 1285939777
Provider Name (Legal Business Name): EMILY KATHERINE HANDLEY.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14227 E HIGHWAY 40
KANSAS CITY MO
64136-1187
US

IV. Provider business mailing address

PO BOX 702620
TULSA OK
74170-2620
US

V. Phone/Fax

Practice location:
  • Phone: 405-751-7131
  • Fax: 405-751-7160
Mailing address:
  • Phone: 405-751-7131
  • Fax: 405-751-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number015684
License Number StateMO

VIII. Authorized Official

Name: JENNIFER CHAMBERS
Title or Position: CHIEF DENTAL DIRECTOR
Credential: DDS
Phone: 405-753-1237