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General NPI Number Information
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NPI Number | 1558453936
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Entity Type | Organization
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Legal Business Name | NICHOLAS W KANAKARES JR DDS PA
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 601 NO MUR LEN STE 22
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City | OLATHE
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State | KS
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Zip | 66062-5451
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Country | US
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Telephone | 913-829-4099
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Fax | 913-829-4874
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Provider Business Mailing Address
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Address Line | 601 NO MUR LEN STE 22
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City | OLATHE
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State | KS
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Zip | 66062-5451
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Country | US
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Telephone | 913-829-4099
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Fax | 913-829-4874
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Authorized Official
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Title or Position | DENTIST PRESIDENT
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Name | DR. NICHOLAS WILLIAM KANAKARES JR.
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Credential | DDS
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Telephone | 913-829-4099
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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 | KS4690
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License Number State | KS
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