Precision Dental West, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PRECISION DENTAL WEST, LLC

Practice address

3900 W Central Ave Ste 100
Wichita, KS 67203-4928

Phone

(316) 558-3993

Fax

(316) 558-3995

NPI assigned

Nov 27, 2019

Organization subpart

No

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

Authorized official

Name

Graciela Degroot

Title

Office Manager

Phone

(316) 558-3993

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1851937650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W CENTRAL AVE STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034928",
            "telephone_number": "316-558-3993",
            "fax_number": "316-558-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W CENTRAL AVE STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034928",
            "telephone_number": "316-558-3993",
            "fax_number": "316-558-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION DENTAL WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "DEGROOT",
        "authorized_official_first_name": "GRACIELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "316-558-3993"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.