Carol M. Ysidro, D.D.S.,P.a.

Organization Active NPI Public Health Dentistry · Derby, KS

NPI 1992865612 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1992865612
Entity type
Organization (NPI type 2)
Primary specialty
Public Health Dentistry 1223D0001X
License
60024 (KS)
Legal business name
CAROL M. YSIDRO, D.D.S.,P.A.
Practice address
900 E. Meadowlark
Derby, KS 67037-5258
Phone
(316) 788-2118
Fax
(316) 789-9098
NPI assigned
Dec 11, 2006
Organization subpart
No

Authorized official

Name
Mr. Monte Ysidro
Title
Business Manager
Phone
(316) 788-2118

Practitioners 1

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223D0001X 60024 KS Yes

Addresses

Primary practice location

900 E. Meadowlark
Derby, KS 67037-5258

Mailing address

PO Box 1258
900 E. Meadowlark
Derby, KS 67037-5258
Phone (316) 788-2118

Other providers in Derby, KS

All providers in Derby, KS · Public Health Dentistry in Kansas

Sources for this page

Verify at the official NPI Registry.