NPIMap

Organization Active NPI

My Dentist Wichita, PA

Doing business as Wheatland Family Dental

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1467872325
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MY DENTIST WICHITA, PA
Doing business as
Wheatland Family Dental
Practice address
1443 N Rock Rd
Wichita, KS 67206-1245
Phone
(316) 295-2830
NPI assigned
Apr 18, 2014
Last updated
Oct 27, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MY DENTIST WICHITA, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1443 N Rock Rd
Wichita, KS 67206-1245

Mailing address

1443 N Rock Rd
Wichita, KS 67206-1245

Other names 1

  • Wheatland Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Dentist Wichita DDS PA2 organizations share this tax ID, including this one
Part of
My Dentist Wichita DDS PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1467872325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 N ROCK RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 N ROCK RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061245",
            "telephone_number": "316-295-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DENTIST WICHITA, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY DENTIST WICHITA, PA",
        "enumeration_date": "2014-04-18",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheatland Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.