OVERLAND PARK MODERN DENTISTRY PA (NPI# 1215367172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215367172 |
| Entity Type | Organization |
| Organization Name | OVERLAND PARK MODERN DENTISTRY PA |
| Other Organization Name | OVERLAND PARK MODERN DENTISTRY |
| Practice Address |
13316 Metcalf Ave Overland Park KS 66213-2804 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 9138515110 |
| Practice Fax Number | 9138510321 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |
| Authorized Official Name | DR. MATTHEW H YIP (OWNER) |
| Authorized Official Telephone | 9138515110 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Overland Park Modern Dentistry | Doing Business As Name - Organization |
| Street Address |
13316 METCALF AVE |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66213-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033727821 | Rachel Michelle Slenker | Dentist | 13316 Metcalf Ave, Overland Park, KS 66213-2804 | 2020-07-17 |
| 1225697394 | Stacie Jeannelle Fechner | Dentist | 13316 Metcalf Ave, Overland Park, KS 66213-2804 | 2019-06-11 |
| 1316327349 | Swetha T Nagaraju | Dentist | 13316 Metcalf Ave, Overland Park, KS 66213-2804 | 2015-06-04 |
| 1922414168 | Cassandra Collins Mckenzie | Dentist | 13316 Metcalf Ave, Overland Park, KS 66213-2804 | 2014-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003345372 | Nicole Renee Oliphant | Speech-Language Pathologist | 12810 W 133 Pl Apt 3109, Overland Park, KS 66213 | 2017-06-08 |
| 1770026874 | Alyssa Potter | Physical Therapy Assistant | 12202 Goodman St, Overland Park, KS 66213 | 2016-11-22 |
| 1164809380 | Jessica Richter | Family Medicine | 10100 W 119th St Ste 150, Overland Park, KS 66213 | 2015-04-27 |
| 1891180816 | Naresh Kumar Dugal | Podiatrist | 13410 Westgate St Apt 2110, Overland Park, KS 66213 | 2015-04-06 |
| 1801219456 | Denise Ahnen | Lactation Consultant, Non-RN | 121300 Metcalf Ave, Overland Park, KS 66213 | 2014-01-31 |
| 1407294986 | Blue Valley Asc, P.a. | Clinic/Center | 12800 Metcalf Avenue Suite 2, Overland Park, KS 66213 | 2013-06-06 |
| 1023455326 | Duncan Arnold Killen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12542 W. 123rd Terr., Overland Park, KS 66213 | 2013-05-28 |
| 1821432345 | Seniorbridge Family Companies (mo), Inc. | In Home Supportive Care | 7304 W. 130th Street, Suite 100, Overland Park, KS 66213 | 2013-04-26 |
| 1538427273 | Charles E Emms D.c., Pa | Chiropractor | 11960 West 119th Street, 11960, Overland Park, KS 66213 | 2012-05-01 |
| 1194000570 | Phoenix Healthcare Clinic | Family Medicine | 11960 Quivira Road, Suite #100, Overland Park, KS 66213 | 2011-10-17 |
| Find all providers in zip 66213 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801457395 | Pinky Kingrani | Dentist | 8033 W 159th St, Overland Park, KS 66223-2914 | 2019-06-25 |
| 1437625258 | Tho Huu Do | Dentist | 12629 W 110th Ter, Overland Park, KS 66210-1275 | 2018-10-19 |
| 1609313469 | Bluhawk Dental Group, Pa | Dentist | 8033 W 159th Street, Overland Park, KS 66085 | 2017-01-31 |
| 1578839759 | Sunny Rajendra Patel | Dentist | 10925 Antioch Rd Ste 201, Overland Park, KS 66210-2119 | 2012-04-01 |
| 1669670568 | Winnie Lam | Dentist | 10827 Woodward St, Overland Park, KS 66210-1617 | 2007-07-03 |
| 1417150939 | Talence Taremeredzwa Kasiyamhuru | Dentist | 6916 W 135th St, Overland Park, KS 66223-4800 | 2007-06-11 |
| 1891905758 | Barry John Burgess | Dentist | 4461 Indian Creek Pkwy, Overland Park, KS 66207-4013 | 2007-05-22 |
| 1215158274 | Reginald Reif | Dentist | 9900 Hardy Dr, Overland Park, KS 66212-3483 | 2007-05-01 |
| 1306965181 | Matthew Hillman | Dentist | 14700 Metcalf Ave, Suite 110, Overland Park, KS 66223 | 2007-03-29 |
| 1275657496 | Grace Dental, P.a. | Dentist | 12611 Antioch Rd, Overland Park, KS 66213 | 2007-03-16 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66213 |
Please comment or provide details below to improve the information on OVERLAND PARK MODERN DENTISTRY PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.