NPIMap

Organization Active NPI

Wichita Endodontics LLC

  • Dental Clinic/Center
  • Wichita, KS
National Provider Identifier
1568048809
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WICHITA ENDODONTICS LLC
Practice address
7721 W 21St St
Wichita, KS 67205
Phone
(316) 681-1099
Fax
(316) 613-2417
NPI assigned
Mar 18, 2021
Organization subpart
Yes
Parent organization
WICHITA ENDODONTICS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Jill Cornelison
Title
Office Manager
Phone
(316) 681-1099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

7721 W 21St St
Wichita, KS 67205

Mailing address

7721 W. 21St Street
Wichita, KS 67205-1737
Phone (316) 681-1099

Other practice location 1

7721 W 21st Street
Wichita, KS 67205-1737
Phone (316) 681-1099

National Provider Directory

National Provider Directory
Tax ID family
Wichita Endodontics LLC3 organizations share this tax ID, including this one
Part of
Wichita Endodontics LLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1568048809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7721 W. 21ST STREET",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051737",
            "telephone_number": "316-681-1099",
            "fax_number": "316-613-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7721 W 21ST ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-681-1099",
            "fax_number": "316-613-2417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7721 W 21st Street",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672051737",
            "country_code": "US",
            "telephone_number": "316-681-1099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WICHITA ENDODONTICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WICHITA ENDODONTICS LLC",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "CORNELISON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "316-681-1099"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 18, 2021; 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.