MIDWEST ORAL & MAXILLOFACIAL SURGERY, PA (NPI# 1114162104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114162104 |
Entity Type | Organization |
Organization Name | MIDWEST ORAL & MAXILLOFACIAL SURGERY, PA |
Practice Address |
11551 Granada Lane 100 Leawood KS 66211-1914 |
Practice Telephone | 9134914488 |
Practice Fax Number | 9134915073 |
Mailing Telephone | 9134914488 |
Mailing Fax Number | 9134915073 |
Enumeration Date | 2008-12-05 |
Last Update Date | 2012-11-15 |
Authorized Official Name | DR. STEVEN D GREEN (D.D.S.) |
Authorized Official Telephone | 9133346000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
Street Address |
11551 GRANADA LANE 100 |
City | LEAWOOD |
State | KS |
Zip Code | 66211-1914 |
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 |
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Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396362638 | Philip J Gordon Dds Pa | Dentist | 3628 W 95th St, Leawood, KS 66206-2035 | 2020-07-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902170483 | Matthew C. Lowe Dds Inc | Dentist | 2711 S. Rouse St., Ste A, Mt. Carmel Plaza, Pittsburg, KS 66762 | 2012-03-01 |
1639449259 | John R Provenzano Dds,pa | Dentist | 1515 S Clifton Ave Ste 120, Wichita, KS 67218-2951 | 2012-01-12 |
1013220813 | Kenneth W. Nelson, Dds, Pa | Dentist | 1919 N. Webb Rd, Wichita, KS 67206-3405 | 2010-07-21 |
1699099465 | Mohammad Nomani | Dentist | 4201 Anderson Ave Ste E, Manhattan, KS 66503-7603 | 2010-03-22 |
1578724225 | Matthew C. Lowe, Dds, PC | Dentist | 2711 S Rouse St Ste A, Pittsburg, KS 66762-6621 | 2008-06-24 |
1144403536 | Brendan Bell | Dentist | 2004 Clock Tower Plz # 130, Manhattan, KS 66503-6403 | 2007-12-10 |
1114106739 | S Kirk Vincent D.d.s., L.c. | Dentist | 4811 Bob Billings Parkway, Suite A, Lawrence, KS 66049 | 2007-10-31 |
1992843510 | Richard Martin Oakley | Dentist | 5811 Nall Ave, Mission, KS 66202-2731 | 2007-02-03 |
1912077116 | Emporia Oral Surgery Lc | Dentist | 2510 W 15th Ave, Emporia, KS 66801-6102 | 2006-11-08 |
1356423495 | Ottawa Oral Surgery Lc | Dentist | 107 E 23rd St, Ste 3 Ottawa Oral Surgery Lc, Ottawa, KS 66067 | 2006-10-19 |
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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.