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General NPI Number Information
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NPI Number | 1063517290
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Entity Type | Organization
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Legal Business Name | HEARTLAND FAMILY DENTISTRY INC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 8355 N CONGRESS AVE
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City | KANSAS CITY
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State | MO
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Zip | 64152-2041
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Country | US
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Telephone | 816-587-9500
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Fax | 816-587-9501
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Provider Business Mailing Address
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Address Line | 8355 N CONGRESS AVE
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City | KANSAS CITY
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State | MO
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Zip | 64152-2041
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Country | US
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Telephone | 816-587-9500
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Fax | 816-587-9501
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. SCOTT M NGUYEN
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Credential | DDS
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Telephone | 816-587-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 015729
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License Number State | MO
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