MEDICARE: DR. STEPHANIE MICHELLE WARDEN 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	1223G0001X	General Practice Dentistry	7167	KS

General Provider Information

NPI Number	:	1437138633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE MICHELLE WARDEN DDS

Provider Business Mailing Address
First Line	:	2200 WEST 75TH STREET
Second Line	:	SUITE 101
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-2517
Country	:	US
Telephone Number	:	913-825-2500
Fax Number	:	913-825-2501

Provider Business Practice Location Address
First Line	:	2200 WEST 75TH STREET
Second Line	:	SUITE 101
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-2517
Country	:	US
Telephone Number	:	913-825-2500
Fax Number	:	913-825-2501

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	07/08/2007

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