NPIMap

Organization Active NPI

Foundation Periodontics, PA

  • Periodontics
  • Lenexa, KS
National Provider Identifier
1295819951
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
7104, 7097 Issued in KS
Legal business name
FOUNDATION PERIODONTICS, PA
Practice address
8704 Bourgade St
Suite 100
Lenexa, KS 66219-1440
Phone
(913) 894-9962
Fax
(913) 894-9972
NPI assigned
Oct 25, 2006
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. John Kevin Mowry, DDS, MSNPI 1568546216
Title
President
Phone
(913) 894-9962

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 7104, 7097 KS Primary

Addresses

Primary practice location

8704 Bourgade St
Suite 100
Lenexa, KS 66219-1440

Mailing address

8704 Bourgade St
Suite 100
Lenexa, KS 66219-1440
Phone (913) 894-9962

National Provider Directory

National Provider Directory

Locations

8704 Bourgade St
Ste 100
Lenexa, KS 66219
Phone (913) 894-9962

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295819951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8704 BOURGADE ST",
            "address_2": "SUITE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191440",
            "telephone_number": "913-894-9962",
            "fax_number": "913-894-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8704 BOURGADE ST",
            "address_2": "SUITE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191440",
            "telephone_number": "913-894-9962",
            "fax_number": "913-894-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION PERIODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOWRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-894-9962",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "7104, 7097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, 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.