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General NPI Number Information
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NPI Number | 1780970327
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Entity Type | Individual
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Provider Name | JOHN A DEAKINS DDS
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Gender | Male
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 6 VICTORY LN STE 1
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City | LIBERTY
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State | MO
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Zip | 64068-3805
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Country | US
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Telephone | 816-781-7280
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Fax | 816-781-7568
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Provider Business Mailing Address
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Address Line | 6416 N COSBY AVE
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City | KANSAS CITY
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State | MO
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Zip | 64151-2377
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Country | US
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Telephone | 573-823-3612
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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 | 2011018553
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License Number State | MO
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