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General NPI Number Information
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NPI Number | 1801358676
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Entity Type | Individual
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Provider Name | DENNIS SOURVANOS DDS
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Gender | Male
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 9018 N SKYVIEW AVE
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City | KANSAS CITY
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State | MO
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Zip | 64154-8501
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Country | US
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Telephone | 816-741-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 EASTERN BLVD
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City | YORK
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State | PA
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Zip | 17402-2818
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Country | US
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Telephone | 717-755-1200
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS042481
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License Number State | PA
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