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NPI Code Detail

MEDICARE: DR. CHARLES BRYON HALEY DDS

MEDICARE: DR. CHARLES BRYON HALEY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry7151KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127440032OTHERMOBCBS
2388559OTHERKSBCBS

General Provider Information

NPI Number : 1023089968
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES BRYON HALEY DDS
Provider Business Mailing Address
First Line : 8137 PARALLEL PKWY
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112
Country : US
Telephone Number : 913-299-8900
Fax Number : 913-299-2022
Provider Business Practice Location Address
First Line : 8137 PARALLEL PKWY
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112
Country : US
Telephone Number : 913-299-8900
Fax Number : 913-299-2022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 07/08/2007

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