ADVENTURE DENTAL AND VISION (TWIN LAKES DENTAL PA) NPI 1003027749

Dentist (General Practice) in Wichita, KS

NPI 1003027749 Organization Dentist General Practice

About ADVENTURE DENTAL AND VISION (TWIN LAKES DENTAL PA)

Adventure Dental And Vision (twin Lakes Dental Pa) is a provider established in Wichita, Kansas specializing in dentist (general practice) . The NPI number of Adventure Dental And Vision (twin Lakes Dental Pa) is 1003027749 and was assigned on May 2007. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Adventure Dental And Vision (twin Lakes Dental Pa) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Adventure Dental And Vision. The authorized official of this NPI record is Shaun Urbanozo (Credentialing Manager)

A dentist like Adventure Dental And Vision is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

NPI

1003027749

Provider NameADVENTURE DENTAL AND VISION (TWIN LAKES DENTAL PA)
Provider Location Address1901 W 21ST ST WICHITA, KS 67203
Provider Mailing Address2221 E BIJOU ST STE 100 COLORADO SPRINGS, CO 80909
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameADVENTURE DENTAL AND VISION
Other Name TypeDoing Business As (3)
Enumeration Date05-24-2007
Last Update Date10-22-2019


Primary Taxonomy

Taxonomy Code1223G0001X
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
License StateKS
Taxonomy DescriptionA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Business Address

ADVENTURE DENTAL AND VISION
1901 W 21ST ST
WICHITA, KS
ZIP 67203
Phone: (316) 832-2838
Fax: (316) 832-9530

Get Directions


Mailing Address

ADVENTURE DENTAL AND VISION
2221 E BIJOU ST STE 100
COLORADO SPRINGS, CO
ZIP 80909
Phone: (719) 955-8896
Fax: (719) 955-3470



Authorized Official

Authorized Official Name SHAUN URBANOZO
Authorized Official TitleCREDENTIALING MANAGER
Authorized Official Phone(719) 323-2362

Group Taxonomy


193400000X MULTIPLE SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
11223G0001XDental ProvidersDentistGeneral Practice60387KSNo

Taxonomy Description: a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
200432580AMEDICAID (05)KS
200420170BMEDICAID (05)KS
60387OTHER (01)KS

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.