BLUE VALLEY PEDIATRIC DENTISTRY LLC NPI 1942795976

NPI Information

BLUE VALLEY PEDIATRIC DENTISTRY LLC is a pediatric dentistry dentist in Overland Park, KS. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. BLUE VALLEY PEDIATRIC DENTISTRY LLC NPI is 1942795976. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7560 W 160TH ST
OVERLAND PARK, KS
ZIP 66085
Phone: (913) 232-2708
Fax: (913) 232-2718

The provider's authorized official is Vanessa Renee Axelsen .
The authorized official title is Owner and has the following contact phone number (913) 232-2708.

The CLIA number assigned to this NPI record is 17D1105979 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/22/2018 and was last updated on 10/18/2022.

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:

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