MEDICARE: KENNETH J WEINAND DDS PC

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	305S00000X	Point of Service	MO12756	MO

General Provider Information

NPI Number	:	1447550744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNETH J WEINAND DDS PC

Provider Business Mailing Address
First Line	:	14500 E 42ND ST S
Second Line	:	SUITE 210
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-4700
Country	:	US
Telephone Number	:	816-478-4244
Fax Number	:	816-478-2404

Provider Business Practice Location Address
First Line	:	14500 E 42ND ST S
Second Line	:	SUITE 210
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-4700
Country	:	US
Telephone Number	:	816-478-4244
Fax Number	:	816-478-2404

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KENNETH J WEINAND
Credential	:	DDS
Telephone Number	:	816-478-4244

Provider Enumeration Date	:	11/02/2010
Last Update Date	:	11/02/2010

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