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General NPI Number Information
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NPI Number | 1083485825
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Entity Type | Individual
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Provider Name | DR. MEHTAB WARYA
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Gender | Female
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 14433 MAPLE ST
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City | OVERLAND PARK
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State | KS
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Zip | 66223-1256
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Country | US
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Telephone | 913-269-5947
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Fax |
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Provider Business Mailing Address
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Address Line | 14433 MAPLE ST
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City | OVERLAND PARK
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State | KS
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Zip | 66223-1256
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | LL-560-81
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 62087
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License Number State | KS
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