MEDICARE: PRETTY SMILES DENTISTRY P.C.

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

General Provider Information

NPI Number	:	1962353524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRETTY SMILES DENTISTRY P.C.

Provider Business Mailing Address
First Line	:	5240 PROSPECT AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2915
Country	:	US
Telephone Number	:	816-921-8187
Fax Number	:	816-921-2086

Provider Business Practice Location Address
First Line	:	5240 PROSPECT AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2915
Country	:	US
Telephone Number	:	816-921-8187
Fax Number	:	816-921-2086

Authorized Official
Title or Position	:	OWNER
Name	:	MYERS NGOMSI
Credential	:	DDS
Telephone Number	:	816-921-8187

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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