Cornerstone Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

CORNERSTONE ENDODONTICS

Practice address

4601 W 109TH Street Suite 325
Overland Park, KS 66211

Phone

(913) 498-3636

Fax

(913) 498-0935

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Colleen S Huls

Title

Office Manager

Phone

(913) 498-3636

Specialties & licenses 1

Addresses

Other names 1

• M Michael Randall DDS PA Former legal business name

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962579219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH STREET SUITE 325",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66211",
            "telephone_number": "913-498-3636",
            "fax_number": "913-498-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH STREET SUITE 325",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66211",
            "telephone_number": "913-498-3636",
            "fax_number": "913-498-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HULS",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "913-498-3636",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M Michael Randall DDS PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Overland Park, KS
• Endodontics in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.