MEDICARE: ROBERT OLIVER WEISS 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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	2023007573	MO
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	62052	KS

General Provider Information

NPI Number	:	1124576723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT OLIVER WEISS DDS

Provider Business Mailing Address
First Line	:	9729 SAGAMORE RD
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66206-2313
Country	:	US
Telephone Number	:	314-609-2227
Fax Number	:

Provider Business Practice Location Address
First Line	:	12184 NATURAL BRIDGE RD
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2017
Country	:	US
Telephone Number	:	314-391-4936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	03/17/2026

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