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General NPI Number Information
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NPI Number | 1316750177
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Entity Type | Individual
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Provider Name | NEWTON ISAAC PEREZ
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Gender | Male
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 7207 E 21ST ST N
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City | WICHITA
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State | KS
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Zip | 67206-3916
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Country | US
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Telephone | 316-681-2688
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Fax |
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Provider Business Mailing Address
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Address Line | 202 WYBURN PL
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City | BURNS
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State | TN
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Zip | 37029-5110
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Country | US
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Telephone | 646-287-6246
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 62408
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License Number State | KS
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