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NPI Code Detail

MEDICARE: DENTAL CARE INDEPENDENCE

MEDICARE: DENTAL CARE INDEPENDENCE
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 Dentistry2008019818MO

General Provider Information

NPI Number : 1407205099
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL CARE INDEPENDENCE
Provider Business Mailing Address
First Line : 10800 FARLEY ST
Second Line : STE. 200
City : OVERLAND PARK
State : KS
Zip : 66210-1414
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3908 S NOLAND RD
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64055-3347
Country : US
Telephone Number : 816-461-2273
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : SHAYNA BAHR
Credential : DMD
Telephone Number : 303-524-4501
Provider Enumeration Date : 06/06/2016
Last Update Date : 06/06/2016

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Directions to “DENTAL CARE INDEPENDENCE ” Practice Location

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