John R Provenzano Dds,Pa

LBN: John R Provenzano Dds,Pa
John R Provenzano Dds,Pa is an health care organization with primary practice located at 1515 S Clifton Ave Ste 120 , Wichita KS 67218-2951. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. John R Provenzano Dds,Pa can be contacted via phone (316) 681-3757, or through Provenzano, John R via phone (316) 681-3757.

Contact Information

Primary practice address
1515 S Clifton Ave Ste 120 Wichita KS 67218-2951
Phone: (316) 681-3757
Fax: (316) 652-0602
Website:
Map and Directions
Authorized official contact:
Name: Provenzano, John R DDS,PA
Phone: (316) 681-3757

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 6557 Kansas

Profile Details

NPI number 1639449259
LBN Legal business name John R Provenzano Dds,Pa
DBA Doing business as
Authorized official Provenzano, John R DDS,PA
Entity Organization
Organization subpart 1 No
Enumeration date Jan 12th, 2012
Last updated Feb 9th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639449259 NPPES
Kansas Other 019243 MEDICARE P-TAN

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