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NPI Code Detail

MEDICARE: KAPILIKISHA DMD LLC

MEDICARE: KAPILIKISHA DMD LLC
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 Dentistry

General Provider Information

NPI Number : 1528716172
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAPILIKISHA DMD LLC
Provider Business Mailing Address
First Line : PO BOX 70887
Second Line :
City : CLEVELAND
State : OH
Zip : 44190-0887
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1193 BRANSON HILLS PKWY
Second Line :
City : BRANSON
State : MO
Zip : 65616-9942
Country : US
Telephone Number : 417-213-3025
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MUKUKA KAPILIKISHA
Credential :
Telephone Number : 417-213-3025
Provider Enumeration Date : 03/14/2022
Last Update Date : 06/20/2023

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Directions to “KAPILIKISHA DMD LLC ” Practice Location

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