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General NPI Number Information
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NPI Number | 1609618115
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Entity Type | Individual
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Provider Name | MOLLIE W MAUPIN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 6811 W 121ST ST
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City | LEAWOOD
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State | KS
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Zip | 66209-2005
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Country | US
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Telephone | 913-270-6846
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Fax |
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Provider Business Mailing Address
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Address Line | 7201 W 80TH ST APT 407
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City | OVERLAND PARK
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State | KS
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Zip | 66204-3765
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Country | US
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Telephone | 816-896-6818
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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 | 62161
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License Number State | KS
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