MEDICARE: KC ORAL & FACIAL SURGICAL INSTITUTE 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
1	261QS0112X	Oral and Maxillofacial Surgery Clinic/Center

General Provider Information

NPI Number	:	1659013712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KC ORAL & FACIAL SURGICAL INSTITUTE LLC

Provider Business Mailing Address
First Line	:	4225 BALTIMORE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2304
Country	:	US
Telephone Number	:	816-753-4225
Fax Number	:	816-753-4226

Provider Business Practice Location Address
First Line	:	4225 BALTIMORE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2304
Country	:	US
Telephone Number	:	816-753-4225
Fax Number	:	816-753-4226

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEVEN J PRSTOJEVICH
Credential	:	MD, DDS, FACS
Telephone Number	:	816-820-4411

Provider Enumeration Date	:	04/10/2022
Last Update Date	:	04/10/2022

Similar Medicare Providers

1740847755 — DR. ROBERT KEITH TWILLMAN PHD
Practice Location Address:

4225 BALTIMORE AVE
KANSAS CITY, MO
64111-2304

Practice Phone: 816-932-1711
Practice Fax: 816-932-1719

1720063134 — MAHESH PATEL, MD,PC
Practice Location Address:

1509 NE PARVIN RD
NORTH KANSAS CITY, MO
64116-2304

Practice Phone: 816-283-3396
Practice Fax: 913-685-0622

1225042690 — ELIZABETH JOAN FRIEDMAN M.D.
Practice Location Address:

4000 CAMBRIDGE ST
KANSAS CITY, KS
66160-2304

Practice Phone: 913-588-7301
Practice Fax:

1598828147 — CREATIVE SUPPORTS, INC
Practice Location Address:

1511 NE PARVIN RD
KANSAS CITY, MO
64116-2304

Practice Phone: 816-452-6194
Practice Fax: 816-454-3211

1063824068 — YONATAN GIZAW M.D.
Practice Location Address:

4000 CAMBRIDGE 6040 DELP MS 1020
KANSAS CITY, KS
66160-2304

Practice Phone: 913-588-6005
Practice Fax:

1831603885 — LARRY JAMES LAUVETZ MA LPC
Practice Location Address:

1509 NE PARVIN RD
KANSAS CITY, MO
64116-2304

Practice Phone: 816-471-2276
Practice Fax: 816-471-1579

Directions to “KC ORAL & FACIAL SURGICAL INSTITUTE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.