MEDICARE: MOHAMED KAPLAN DMD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	36090	TX

General Provider Information

NPI Number	:	1396238820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED KAPLAN DMD

Provider Business Mailing Address
First Line	:	2301 HOLMES ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2677
Country	:	US
Telephone Number	:	816-404-4175
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 WEST LOOP
Second Line	:
City	:	EL CAMPO
State	:	TX
Zip	:	77437-8007
Country	:	US
Telephone Number	:	979-543-5221
Fax Number	:

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

Provider Enumeration Date	:	06/09/2018
Last Update Date	:	05/08/2020

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