MEDICARE: DR. STEVEN D PENDLETON 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	7128	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770571952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN D PENDLETON DDS

Provider Business Mailing Address
First Line	:	8919 PARALLEL PKWY
Second Line	:	SUITE #309
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-1636
Country	:	US
Telephone Number	:	913-299-0704
Fax Number	:	913-299-3008

Provider Business Practice Location Address
First Line	:	8919 PARALLEL PKWY
Second Line	:	SUITE #309
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-1636
Country	:	US
Telephone Number	:	913-299-0704
Fax Number	:	913-299-3008

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	11/14/2012

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Directions to “ DR. STEVEN D PENDLETON DDS” Practice Location

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