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General NPI Number Information
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NPI Number | 1508276866
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Entity Type | Individual
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Provider Name | CASEY LEE RHOADS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 15151 S BLACKBOB RD
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City | OLATHE
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State | KS
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Zip | 66062-3301
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Country | US
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Telephone | 913-764-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 W 106TH ST APT 330
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City | LEAWOOD
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State | KS
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Zip | 66206-8515
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Country | US
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Telephone | 402-309-6250
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 61106
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2016029515
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License Number State | MO
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