=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861872475
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DENTAL PARTNERS OF OVERLAND PARK LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2015
-----------------------------------------------------
Last Update Date | 06/09/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8700 SANTA FE DR
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66212-3654
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-416-4660
-----------------------------------------------------
Fax | 913-385-0633
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8700 SANTA FE DR
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66212-3654
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-416-4660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AARON PARKIN
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 913-416-4660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | 61024
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------