Olathe Pediatric Dental, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

OLATHE PEDIATRIC DENTAL, P.A.

Practice address

12708 S Blackbob Rd Ste B
Olathe, KS 66062-1409

Phone

(913) 225-9749

Fax

(913) 490-2910

NPI assigned

Dec 4, 2024

Last updated

Dec 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Creed Cardon, DDS

Title

President

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1902612112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12708 S BLACKBOB RD STE B",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621409",
            "telephone_number": "913-225-9749",
            "fax_number": "913-490-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLATHE PEDIATRIC DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-998-0996",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olathe Medical Center Inc
• Olathe Medical Center Inc (Olathe Health Hospice Care)
• Olathe Medical Center Inc (Olathe Health Home Healthcare)
• Olathe Obstetrics & Gynecology PA
• Olathe Pediatric Dental Care, LLC (Treetop Pediatric Dentistry Olathe)
• Olathe Physical Therapy & Hand Rehab
• Olathe South Dentistry, PA (Olathe South Dentistry)
• Olathe Usd 233
• Olathe West Dentistry, PA (Olathe West Dentistry)
• Olathe Wound and Hyperbaric Associates LLC

• Pediatric Dentistry in Olathe, KS
• Providers in Olathe, KS by specialty
• Pediatric Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.