Kurt Frederick Hanneman, DDS
Individual provider Active NPI General Practice Dentistry · Grain Valley, MO
NPI 1376575480 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376575480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 13480 (MO)
- Practice address
- 655 R.D. Mize Road
Grain Valley, MO 64029 - Phone
- (816) 229-4560
- Fax
- (816) 229-1849
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 13480 | MO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13480 | MO | Yes |
Addresses
Primary practice location
655 R.D. Mize Road
Grain Valley, MO 64029
Mailing address
655 R.D. Mize Road
PO Box 530
Grain Valley, MO 64029
Phone (816) 229-4560
Other providers in Grain Valley, MO
- Ella Guyear
- Aubree Hahn
- Kailey Hall
- Michelle Hampton
- Caitlin Haney
- Thomas Hargrave
- Ashley Hawkins
- Heart to Heart Counseling LLC
- Helping Hands Therapy Services
- Aubree L Hendershot
All providers in Grain Valley, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.