Healthcare Provider Details

I. General information

NPI: 1639748627
Provider Name (Legal Business Name): TANNA BLAIR KUHNERT DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2618 N BELT HWY
SAINT JOSEPH MO
64506-2003
US

IV. Provider business mailing address

478 160TH RD
DENTON KS
66017-4087
US

V. Phone/Fax

Practice location:
  • Phone: 816-364-6467
  • Fax:
Mailing address:
  • Phone: 816-262-6299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number61886
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2021021368
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: