NPIMap

Organization Active NPI

Periodontist PA

  • Periodontics
  • Overland Park, KS
National Provider Identifier
1104948959
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
5544 Issued in KS
Legal business name
PERIODONTIST PA
Practice address
10870 Benson St
BLDG. 21 Suite 2100
Overland Park, KS 66210-1502
Phone
(913) 451-6158
Fax
(913) 451-9463
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stanley L Wint, DDSNPI 1851413660
Title
President
Phone
(913) 451-6158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 5544 KS Primary

Addresses

Primary practice location

10870 Benson St
BLDG. 21 Suite 2100
Overland Park, KS 66210-1502

Mailing address

10870 Benson St
BLDG. 21 Suite 2100
Overland Park, KS 66210-1502
Phone (913) 451-6158

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104948959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10870 BENSON ST",
            "address_2": "BLDG. 21 SUITE 2100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101502",
            "telephone_number": "913-451-6158",
            "fax_number": "913-451-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10870 BENSON ST",
            "address_2": "BLDG. 21 SUITE 2100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101502",
            "telephone_number": "913-451-6158",
            "fax_number": "913-451-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINT",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-451-6158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "5544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.