Aime Andrade, RDH

Individual provider Active NPI Dental Hygienist · Fairway, KS

NPI 1376010777 · NPPES record last updated Oct 24, 2018

Key facts

NPI
1376010777
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
2017044311 (MO)
Practice address
4400 Shawnee Mission Pkwy Ste 208
Fairway, KS 66205-2518
Phone
(913) 254-4065
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12451KSMDDental Hygienist
2017044311MOMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 12451 KS
Dental Hygienist 124Q00000X 2017044311 MO Yes

Addresses

Primary practice location

4400 Shawnee Mission Pkwy Ste 208
Fairway, KS 66205-2518

Mailing address

4400 Shawnee Mission Pkwy Ste 208
Fairway, KS 66205-2518
Phone (913) 254-4065

Other providers in Fairway, KS

All providers in Fairway, KS · Dental Hygienist in Kansas

Sources for this page

Verify at the official NPI Registry.