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General NPI Number Information
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NPI Number | 1295358331
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Entity Type | Individual
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Provider Name | CODY RYAN WELDING DDS
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Gender | Male
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Dates
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Enumeration Date | 05/23/2020
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 4121 W 83RD ST STE 245
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5319
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Country | US
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Telephone | 913-648-6694
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Fax | 913-648-6697
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Provider Business Mailing Address
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Address Line | 4121 W 83RD ST STE 245
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5319
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Country | US
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Telephone | 913-648-6694
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Fax | 913-648-6697
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 61790
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License Number State | KS
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