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NPI Code Detail

MEDICARE: MATTHEW TODD ZIMMERMAN DDS

MEDICARE: MATTHEW TODD ZIMMERMAN 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
11223G0001XGeneral Practice Dentistry2024022033MO

General Provider Information

NPI Number : 1679316707
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW TODD ZIMMERMAN DDS
Provider Business Mailing Address
First Line : 9023 LOWELL AVE
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66212-2937
Country : US
Telephone Number : 913-488-2018
Fax Number :
Provider Business Practice Location Address
First Line : 4546 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1816
Country : US
Telephone Number : 816-931-2342
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2024
Last Update Date : 06/17/2024

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Directions to “ MATTHEW TODD ZIMMERMAN DDS” Practice Location

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