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General NPI Number Information
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NPI Number | 1679639751
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Entity Type | Individual
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Provider Name | KEVIN J CUMMINGS DENTIST
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Gender | Male
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Dates
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Enumeration Date | 12/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 SW WARD RD SUITE 204
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City | LEES SUMMIT
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State | MO
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Zip | 64081-2448
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Country | US
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Telephone | 816-246-1003
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Fax | 816-246-9808
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Provider Business Mailing Address
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Address Line | 1201 W 113TH TER
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City | KANSAS CITY
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State | MO
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Zip | 64114-5259
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Country | US
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Telephone | 816-943-0760
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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 | 13728
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License Number State | MO
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