CLAYCOMO DENTAL GROUP LLC NPI 1205255460

NPI Information

NPI: 1205255460
Provider Name: CLAYCOMO DENTAL GROUP LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
244 E US HIGHWAY 69
SUITE 101
KANSAS CITY, MO
ZIP 64119
Phone: (816) 454-1313
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CLAYCOMO DENTAL GROUP LLC is a dental clinic center in Kansas City, MO. CLAYCOMO DENTAL GROUP LLC NPI is 1205255460. The provider is registered as an organization entity type.

The provider's business location address is:

244 E US HIGHWAY 69
SUITE 101
KANSAS CITY, MO
ZIP 64119-184
Phone: (816) 454-1313
Fax: (816) 454-5377

The provider's authorized official is Bryan Shewanick .
The authorized official title is Dentist and has the following contact phone number (816) 454-1313.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 4/15/2014.

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
1	261QD0000X	Clinic/Center	Dental	2009016386	MISSOURI	Yes

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: 4/28/2024

NPI Synchronization or Removal

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