Individual provider Active NPI

Kathryn Nielson Stanley, DDS

  • Pediatric Dentistry
  • Overland Park, KS
National Provider Identifier
1730390568
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
60472 Issued in KS
Practice address
8575 W 110TH St
Suite 310
Overland Park, KS 66210-1868
Phone
(913) 345-0331
Fax
(913) 345-2601
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 60472 KS Primary

Addresses

Primary practice location

8575 W 110TH St
Suite 310
Overland Park, KS 66210-1868

Mailing address

8575 W. 110TH Street
Suite 310
Overland Park, KS 66210-3011
Phone (913) 345-0331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130819000020 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4789826934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60472KSMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn V. Hemberger, DDS, Ms, CHTD Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1730390568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 W. 110TH STREET",
            "address_2": "SUITE 310",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662103011",
            "telephone_number": "913-345-0331",
            "fax_number": "913-345-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 W 110TH ST",
            "address_2": "SUITE 310",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101868",
            "telephone_number": "913-345-0331",
            "fax_number": "913-345-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "KATHRYN",
        "middle_name": "NIELSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KS",
            "license": "60472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.