NPIMap

Organization Active NPI

Buccal Up Dental Olathe LLC

Doing business as Your Olathe Dentist

  • Dental Clinic/Center
  • Olathe, KS
National Provider Identifier
1972235992
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BUCCAL UP DENTAL OLATHE LLC
Doing business as
Your Olathe Dentist
Practice address
11132 S Lone Elm Rd
Olathe, KS 66061-9434
Phone
(913) 780-0123
Fax
(913) 829-9510
NPI assigned
Jun 28, 2022
Last updated
Jun 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Rebecca Condley
Title
Credentialing Specialist
Phone
(918) 960-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11132 S Lone Elm Rd
Olathe, KS 66061-9434

Mailing address

5314 S Yale Ave Ste 400
Tulsa, OK 74135-6271
Phone (918) 960-3070

Other names 1

  • Your Olathe Dentist Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcondley@buccalupdental.com

National Provider Directory

National Provider Directory

Locations

11132 S Lone Elm Rd
Olathe, KS 66061
Phone (913) 780-0011

Interoperability endpoints

  • Direct secure messaging: bcondley@buccalupdental.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1972235992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5314 S YALE AVE STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356271",
            "telephone_number": "918-960-3070",
            "fax_number": "539-867-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11132 S LONE ELM RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660619434",
            "telephone_number": "913-780-0123",
            "fax_number": "913-829-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCCAL UP DENTAL OLATHE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "CONDLEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "918-960-3070"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcondley@buccalupdental.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "11132 S Lone Elm Rd",
            "city": "Olathe",
            "state": "KS",
            "country_code": "US",
            "postal_code": "660619434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Your Olathe Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.