Michael Bashoura, DDS, MD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Olathe, KS
NPI 1801316435 · NPPES record last updated Aug 22, 2025
Key facts
- NPI
- 1801316435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 62076 (KS)
- Practice address
- 20168 W 153Rd St
Olathe, KS 66062-9131 - Phone
- (913) 839-9709
- NPI assigned
- Jun 24, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 1, 2023 through Aug 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62076 | KS | MD | Oral and Maxillofacial Surgery (Dentist) |
| 2017019368 | MO | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 62076 | KS | Yes |
| Dentist | 122300000X | 2017019368 | MO | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 2017019368 | MO |
Addresses
Primary practice location
20168 W 153Rd St
Olathe, KS 66062-9131
Mailing address
20168 W 153Rd St
Olathe, KS 66062-9131
Phone (913) 839-9709
Other providers in Olathe, KS
- Danielle Longhofer Bartelli
- Sarah Jessica Barth
- Margo Barton
- Michael Barton
- Baseline Medical Equipment and Supplies
- Serita Baskin
- Laura Bassi
- Sheryl R. Bastian
- Angelina Marie Bates
- Gwen Bates
All providers in Olathe, KS · Oral and Maxillofacial Surgery (Dentist) in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.