| Village Complete Dentistry, Llc | |
|
4121 W 83rd St Ste 137 Prairie Village KS 66208-5323 | |
| (913) 381-4700 | |
| Not Available |
| Full Name | Village Complete Dentistry, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4121 W 83rd St Ste 137, Prairie Village, Kansas |
| Authorized Official Name and Position | Blair Edgington Hannaman (MEMBER/DENTIST) |
| Authorized Official Contact | 9133814700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Complete Dentistry, Llc 4121 W 83rd St Ste 137 Prairie Village KS 66208-5323 Ph: (913) 381-4700 | Village Complete Dentistry, Llc 4121 W 83rd St Ste 137 Prairie Village KS 66208-5323 Ph: (913) 381-4700 |
| NPI Number | 1811571896 |
|---|---|
| Provider Enumeration Date | 05/06/2021 |
| Last Update Date | 05/06/2021 |
| Medicare PECOS PAC ID | 7810363256 |
|---|---|
| Medicare Enrollment ID | O20221026001222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811571896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Blair Edgington |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689833519 PECOS PAC ID: 7810200995 Enrollment ID: I20221028000204 |
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Grant R Smith Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 W 83rd St Ste 111, Prairie Village, KS 66208 Phone: 913-659-5600 | |
Erin Flood, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7301 Mission Rd Ste 203, Prairie Village, KS 66208 Phone: 913-362-7320 | |
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