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EL DORADO FAMILY DENTISTRY NPI 1609246404


NPI Information

NPI: 1609246404
Provider Name: EL DORADO FAMILY DENTISTRY
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 17D1006693

Address:
202 N MAIN ST
EL DORADO, KS
ZIP 67042
Phone: (316) 321-0300
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EL DORADO FAMILY DENTISTRY is a general practice dentist in El Dorado, 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. EL DORADO FAMILY DENTISTRY NPI is 1609246404. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

202 N MAIN ST
EL DORADO, KS
ZIP 67042-018
Phone: (316) 321-0300

The provider's authorized official is William S Rasband .
The authorized official title is Dentist and has the following contact phone number (816) 651-7743.

The CLIA number assigned to this NPI record is 17D1006693 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/6/2015 and was last updated on 10/6/2015.


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 Practice60660KANSASNo
21223G0001XDentistGeneral Practice5311KANSASNo
31223G0001XDentistGeneral Practice61136KANSASYes

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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