Individual provider Active NPI

John Andrew Dolenz, D.D.S.

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1417067349
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7124 Issued in KS
Practice address
11820 W 95TH St
Overland Park, KS 66214-1831
Phone
(315) 454-6000
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18482 MD
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7124 KS Primary

Addresses

Primary practice location

11820 W 95TH St
Overland Park, KS 66214-1831

Mailing address

817 Santa Fe St
Atchison, KS 66002-2332
Phone (913) 367-7270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908000672 KS Order and Referring Only - Other (Non-Physician) 4486940095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7124KSMDClinical Social Worker
18482MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John Dolenz CurrentSince Jan 21, 2022 Accepting new patients
HFD LLC PastSince Sep 5, 2023 Accepting new patients

Locations

817 Santa Fe St
Atchison, KS 66002
Phone (913) 367-7270

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1417067349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 SANTA FE ST",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660022332",
            "telephone_number": "913-367-7270",
            "fax_number": "913-367-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662141831",
            "telephone_number": "315-454-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLENZ",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18482",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "7124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.