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WISDOM FAMILY DENTISTRY P.A. NPI 1487670089


NPI Information

NPI: 1487670089
Provider Name: WISDOM FAMILY DENTISTRY, P.A.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
712 6TH ST
CLAY CENTER, KS
ZIP 67432
Phone: (785) 632-2400
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WISDOM FAMILY DENTISTRY, P.A. is a general practice dentist in Clay Center, 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. WISDOM FAMILY DENTISTRY, P.A. NPI is 1487670089. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

712 6TH ST
CLAY CENTER, KS
ZIP 67432-915
Phone: (785) 632-2400
Fax: (785) 632-5893

The provider's authorized official is Eric J Wisdom .
The authorized official title is Owner and has the following contact phone number (785) 632-2400.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 1/4/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice5188AKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100095990BMEDICAIDKANSAS

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

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