NPIMap

Organization Active NPI

Overland Park Dentistry, PA

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1962936740
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6058 Issued in KS
Legal business name
OVERLAND PARK DENTISTRY, PA
Practice address
8100 Marty St
Suite 111
Overland Park, KS 66204-3737
Phone
(913) 341-2380
NPI assigned
Apr 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Authorized official

Name
Dr. Charles Kimes, DDS
Title
Owner
Phone
(913) 341-2380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6058 KS Primary

Addresses

Primary practice location

8100 Marty St
Suite 111
Overland Park, KS 66204-3737

Mailing address

8100 Marty St
Suite 111
Overland Park, KS 66204-3737
Phone (913) 341-2380

National Provider Directory

National Provider Directory
Tax ID family
Overland Park Dentistry PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8100 Marty St
Ste 111
Overland Park, KS 66204
Phone (913) 341-2380

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1962936740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 MARTY ST",
            "address_2": "SUITE 111",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043737",
            "telephone_number": "913-341-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 MARTY ST",
            "address_2": "SUITE 111",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043737",
            "telephone_number": "913-341-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAND PARK DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "KIMES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-341-2380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.