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General NPI Number Information
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NPI Number | 1568699270
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Entity Type | Individual
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Provider Name | JANA M KORTJE DDS
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Gender | Female
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Dates
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Enumeration Date | 06/20/2009
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 4746 BELLEVIEW AVE
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City | KANSAS CITY
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State | MO
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Zip | 64112-1315
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Country | US
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Telephone | 816-531-8740
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Fax |
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Provider Business Mailing Address
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Address Line | 2721 W 67TH TER
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City | MISSION HILLS
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State | KS
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Zip | 66208-1849
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Country | US
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Telephone | 402-841-9387
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 60786
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6843
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2011010552
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License Number State | MO
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