Wichita Family Dental South LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WICHITA FAMILY DENTAL SOUTH LLC

Practice address

1120 N Rock Rd Ste 100
Derby, KS 67037-3587

Phone

(316) 630-9339

NPI assigned

Jan 10, 2020

Last updated

Jan 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie N Brandes, RDH

Title

Clinical Director

Phone

(316) 630-9339

Specialties & licenses 1

Addresses

Other names 2

• Derby Dental Care Other name
• Wichita Family Dental South Other name

Electronic endpoints 1

Practitioners 3

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.

• Brett A Begnoche, D.D.S.

  • Dentist
  • Wichita, KS
  • NPI 1154650794
  NPD (past)
• Michael McDaniel, DDS

  • Dentist
  • Wichita, KS
  • NPI 1699290833
  NPD (past)
• Charles Hardin Pierson, DDS

  • General Practice Dentistry
  • Wichita, KS
  • NPI 1285909168
  NPD (past)

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1194365817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9339 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062971",
            "telephone_number": "316-630-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N ROCK RD STE 100",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373587",
            "telephone_number": "316-630-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FAMILY DENTAL SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "BRANDES",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "316-630-9339",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nikkib@wichitafamilydental.com",
            "affiliation": "N",
            "endpointDescription": "Encrypted company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9339 E 21st St N",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672062971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Derby Dental Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wichita Family Dental South",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wesley Medical Center, LLC (Wesley Derby ER, a department of Wesley Medical Center)
• Brittany Rian West, PTA
• Westview of Derby Rehabilitation & Health Care Center, LLC (Westview of Derby)
• Arthur White, LPC
• Wichita Birth Assistance
• Joshua Wigdahl, PA-C
• Shelby Williams, LMFT
• Wendy L Wilson, LCMFT
• Trista Laine Wisely, OTR/L
• Steven James Wolff, DPT

• Dental Clinic/Center in Derby, KS
• Providers in Derby, KS by specialty
• Dental Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.