| Smiles By The Lake | |
|
6700 W 121st St Ste 101 Overland Park KS 66209-2028 | |
| (913) 451-2540 | |
| Not Available |
| Full Name | Smiles By The Lake |
|---|---|
| Speciality | Dentist |
| Location | 6700 W 121st St Ste 101, Overland Park, Kansas |
| Authorized Official Name and Position | Richard Dean Rhoads (DENTIST) |
| Authorized Official Contact | 3082931061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles By The Lake 6700 W 121st St Ste 101 Overland Park KS 66209-2028 Ph: (913) 451-2540 | Smiles By The Lake 6700 W 121st St Ste 101 Overland Park KS 66209-2028 Ph: (913) 451-2540 |
| NPI Number | 1568976041 |
|---|---|
| Provider Enumeration Date | 11/20/2017 |
| Last Update Date | 03/08/2023 |
| Medicare PECOS PAC ID | 2769848670 |
|---|---|
| Medicare Enrollment ID | O20230519000118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568976041 | NPI | - | NPPES |
| 1508214917 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | 61157 (Kansas) | Secondary |
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