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COUNTRY CLUB DENTAL PA
NPI 1699137109
Dentist - General Practice in Topeka, KS

Active since March 23, 2016
400 SW 29TH ST, SUITE M, TOPEKA, KS 66611(785) 783-5981(785) 783-5982 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 9, 2025, Oct 22, 2019, Jun 19, 2019 and 2 more (5 updates tracked since 2016).

About Country Club Dental Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY CLUB DENTAL PA (NPI 1699137109), doing business as Adventure Dental And Vision, is a healthcare organization registered as a general practice in Topeka, Kansas and active in the NPI registry since March 2016. The organization lists Shaun Urbanozo, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1699137109
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCOUNTRY CLUB DENTAL PA
Location Address400 SW 29TH ST, SUITE MTopeka, KS 66611-1164
Mailing Address2221 E Bijou St, Ste 100Colorado Springs, CO 80909-8009 · (719) 576-1850 · Fax (719) 955-3470
Phone(785) 783-5981
Fax(785) 783-5982
Organization SubpartNo
Authorized OfficialShaun UrbanozoCredentialing Manager · (719) 323-2362
Enumeration DateMarch 23, 2016
Last NPPES UpdateSeptember 9, 20255 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2025
✔ NPI 1699137109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.

Other Names 1

Doing Business AsAdventure Dental And Vision

Other Identifiers 1

Medicaid201199030AKS

Group Practice 1

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Country Club Dental PA's NPI number?

The NPI number for Country Club Dental PA is 1699137109. It was assigned to this organization in the NPPES registry on March 23, 2016. The provider is doing business as Adventure Dental and Vision.

Where is Country Club Dental PA located?

Country Club Dental PA is located at 400 SW 29th St Suite M, Topeka, KS 66611. The listed phone number is (785) 783-5981.

What is Country Club Dental PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Country Club Dental PA accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Country Club Dental PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Country Club Dental PA was last updated on September 9, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.