SPECIAL CARE DENTAL OF MISSOURI LLC (NPI# 1790127512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790127512 |
| Entity Type | Organization |
| Organization Name | SPECIAL CARE DENTAL OF MISSOURI LLC |
| Practice Address |
11111 Nall Ave Suite 100 Leawood KS 66211-1924 |
| Mailing Address |
12910 Shelbyville Rd Ste 300 Louisville KY 40243-2404 |
| Practice Telephone | 5022442441 |
| Practice Fax Number | 5022544086 |
| Mailing Telephone | 5022442441 |
| Mailing Fax Number | 5022544086 |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2016-12-09 |
| Authorized Official Name | LESLIE SEPANEK (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5028134415 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| Y | 122300000X | Dentist | Dental Providers |
| Street Address |
11111 NALL AVE SUITE 100 |
| City | LEAWOOD |
| State | KS |
| Zip Code | 66211-1924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942209366 | Lynn Daniel Ketchum | Specialist | 11111 Nall Ave, Suite 114, Leawood, KS 66211-1925 | 2005-07-18 |
| 1508262999 | Deborah L. Carle, Ph.d., LLC | Psychologist | 11111 Nall Ave, Site 224, Leawood, KS 66211-1924 | 2014-11-12 |
| 1356783146 | Special Care Dental of Kansas, LLC | Dentist | 11111 Nall Ave, Suite 100, Leawood, KS 66211-1924 | 2013-07-23 |
| 1154769735 | Elh Network, LLC | Preferred Provider Organization | 11111 Nall Ave, Suite 220, Leawood, KS 66211-1924 | 2013-06-05 |
| 1215253570 | Angela Giegerich | Nurse Practitioner | 11111 Nall Ave, Suite 222, Leawood, KS 66211-1924 | 2010-04-12 |
| 1306177696 | Ilene Beth Grunspan | Social Worker | 11111 Nall Ave, Suite 103, Leawood, KS 66211-1924 | 2010-01-26 |
| 1447486642 | Ian James Krusich | Dentist | 11111 Nall Ave, 106, Leawood, KS 66211-1924 | 2009-06-03 |
| 1750563458 | Lynn D. Ketchum, M.d. | Plastic Surgery | 11111 Nall Ave, Ste 114, Leawood, KS 66211-1625 | 2007-12-04 |
| 1861607657 | Robert R. Edwards | Dentist | 11111 Nall Ave, Suite 114, Leawood, KS 66211-1620 | 2007-05-14 |
| 1366561839 | Suzan K Coulter | Marriage & Family Therapist | 11111 Nall Ave, Suite 112, Leawood, KS 66211-1625 | 2007-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558854455 | Juliette Dennis | Dentist | 13400 Roe Ave, Leawood, KS 66209-3412 | 2018-06-14 |
| 1780043018 | Robert D. Long Dds, Pa | Dentist | 11111 Nall Ave Ste 109, Leawood, KS 66211-1625 | 2016-02-15 |
| 1134416654 | Tyler Webb | Dentist | 4501 College Blvd Ste 270, Leawood, KS 66211-2332 | 2011-07-05 |
| 1922137074 | Robert Busetti | Dentist | 10346 State Line Road, Leawood, KS 66206 | 2007-03-05 |
| 1972601714 | Melinda A Garcia | Dentist | 7930 Lee Blvd, Leawood, KS 66206-1215 | 2006-09-20 |
| 1336259175 | Mary S Anderson | Dentist | 11305 Ash, Leawood, KS 66211-1643 | 2006-08-30 |
| 1801896386 | James Kevin Ruse | Dentist | 4839 W 135th St, Leawood, KS 66224 | 2005-07-27 |
| 1023635398 | Yasmin Hussein | Dentist | 5321 W 151st St, Leawood, KS 66224-9637 | 2020-07-02 |
| 1033779178 | Clare Elizabeth Espinosa | Dentist | 11313 Ash St, Leawood, KS 66211-1643 | 2019-06-20 |
| 1700235595 | Kenneth Connelly | Dentist | 3711 W 133rd St, Leawood, KS 66209-3347 | 2016-06-13 |
| Find all providers in LEAWOOD | ||||
Please comment or provide details below to improve the information on SPECIAL CARE DENTAL OF MISSOURI LLC.
| 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.