Organization Active NPI

S Kirk Vincent D.D.S., L.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lawrence, KS
National Provider Identifier
1114106739
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6362 Issued in KS
Legal business name
S KIRK VINCENT D.D.S., L.C.
Practice address
4811 Bob Billings Parkway
Suite a
Lawrence, KS 66049
Phone
(785) 841-2902
Fax
(785) 841-5312
NPI assigned
Oct 31, 2007
Last updated
Nov 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Authorized official

Name
Rhonda Vincent
Title
Office Manager
Phone
(785) 841-2902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6362 KS Primary

Addresses

Primary practice location

4811 Bob Billings Parkway
Suite a
Lawrence, KS 66049

Mailing address

4811 Bob Billings Parkway
Suite a
Lawrence, KS 66049
Phone (785) 841-2902

Other identifiers 1

IdentifierTypeStateIssuer
420714OtherPTAN

National Provider Directory

National Provider Directory

Locations

4811 Bob Billings Pkwy
Lawrence, KS 66049
Phone (785) 841-2902

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1114106739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 BOB BILLINGS PARKWAY",
            "address_2": "SUITE A",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "66049",
            "telephone_number": "785-841-2902",
            "fax_number": "785-841-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 BOB BILLINGS PARKWAY",
            "address_2": "SUITE A",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "66049",
            "telephone_number": "785-841-2902",
            "fax_number": "785-841-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S KIRK VINCENT D.D.S., L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "785-841-2902"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KS",
            "license": "6362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "420714",
            "state": null
        }
    ],
    "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 Nov 30, 2009; 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.