Active NPI
Ise D'Angelo, DMD
- Dentist
- Lawrence, KS
National Provider Identifier
1063176204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61972
- Practice address
- 3110 Nieder Rd
Lawrence, KS 66047-1950 - Phone
- (815) 289-7615
- NPI assigned
- Oct 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61972 | KS | Primary |
Addresses
Primary practice location
3110 Nieder Rd
Lawrence, KS 66047-1950
Mailing address
50 E 13TH St Unit 1904
Kansas City, MO 64106-2947
Phone (815) 289-7615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61972 | KS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1063176204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 E 13TH ST UNIT 1904",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641062947",
"telephone_number": "815-289-7615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3110 NIEDER RD",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660471950",
"telephone_number": "815-289-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'ANGELO",
"first_name": "ISE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-25",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "61972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.