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NPI 1942354998

NPI 1942354998 : SHAUN LYDELL KANION DDS : FT. LEAVENWORTH, KS

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General NPI Number Information
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    NPI Number           |    1942354998
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    Entity Type          |    Individual 
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    Provider Name        |    SHAUN LYDELL KANION DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/23/2007
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    520 POPE AVENUE US ARMY DENTAL ACTIVITY
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    City                 |    FT. LEAVENWORTH
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    State                |    KS
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    Zip                  |    66027
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    Country              |    US
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    Telephone            |    785-239-7241
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    Fax                  |    785-239-7245
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Provider Business Mailing Address
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    Address Line         |    4701 CANAAN LAKE DR 
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    City                 |    KANSAS CITY
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    State                |    KS
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    Zip                  |    66109-3840
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    Country              |    US
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    Telephone            |    785-239-7241
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    Fax                  |    785-239-7245
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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       |    0018545
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    2005015671
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    License Number State |    MO
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