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THE INDIAN SPRINGS DENTAL CLINIC LLC NPI 1144207705


NPI Information

NPI: 1144207705
Provider Name: THE INDIAN SPRINGS DENTAL CLINIC, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
4655 STATE AVE
KANSAS CITY, KS
ZIP 66102
Phone: (913) 287-7977
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THE INDIAN SPRINGS DENTAL CLINIC, LLC is a general practice dentist in Kansas City, KS. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. THE INDIAN SPRINGS DENTAL CLINIC, LLC NPI is 1144207705. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4655 STATE AVE
KANSAS CITY, KS
ZIP 66102-603
Phone: (913) 287-7977
Fax: (913) 287-5022

The provider's authorized official is Jenell Stump .
The authorized official title is Director, Licensing & Credentialing and has the following contact phone number (913) 287-7977.

The enumeration date for this NPI number is 12/26/2005 and was last updated on 3/26/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11144207705MEDICAIDMISSOURI
2200383490AMEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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