DR. JOHN R PROVENZANO DDS
NPI 1710955430
Dentist - Oral and Maxillofacial Surgery in Wichita, KS

Q: What is John Provenzano's NPI number?

The NPI number for John Provenzano is 1710955430. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Q: What is John Provenzano's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for John Provenzano was last updated on October 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 09, 2006

1515 S CLIFTON AVE, SUITE 120, WICHITA, KS 67218(316) 681-3757(316) 652-0602 Get Directions Write a Review

NPPES record last updated: October 11, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. John R Provenzano Dds NPPES

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

DR. JOHN R PROVENZANO DDS (NPI 1710955430) is an individual oral and maxillofacial surgery provider in Wichita, Kansas, licensed in Kansas (6557) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1710955430

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. JOHN R PROVENZANOCredential: DDS

Location Address1515 S CLIFTON AVE, SUITE 120Wichita, KS 67218-2900

Mailing Address1515 S Clifton Ave, Suite 120Wichita, KS 67218-2900 · (316) 681-3757 · Fax (316) 652-0602

Phone(316) 681-3757

Fax(316) 652-0602

Sole ProprietorNo

Enumeration DateMarch 9, 2006

Last NPPES UpdateOctober 11, 2011

✔ NPI 1710955430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in KS · 6557

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1515 S CLIFTON AVE, Wichita, KS 67218

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Other Identifiers 1

Medicare ID-Type Unspecified00019243KS

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 ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER HOWARD PHARMD

Pharmacist

1515 S CLIFTON AVE, SUITE 100
WICHITA, KS 67218

Sedgwick County (316) 689-6100

JASON C. SCHMITZ PHARMD

Pharmacist

1515 S CLIFTON AVE, SUITE 100
WICHITA, KS 67218

Sedgwick County (316) 689-6100

DR. JEFFREY HENNES D.C.

Chiropractor

1515 S CLIFTON AVE, SUITE 270
WICHITA, KS 67218

Sedgwick County (316) 684-4888

ANTONIO P BARBA JR. M.D.

Specialist

1515 S CLIFTON AVE, STE. 450
WICHITA, KS 67218

Sedgwick County (316) 691-2301

MRS. MARYON JOYCE HABTEMARIAM ARNP

Nurse Practitioner (Adult Health)

1515 S CLIFTON AVE, SUITE 201
WICHITA, KS 67218

Sedgwick County (316) 687-9961

TERISA OLSON CRNA

Nurse Anesthetist, Certified Registered

1515 S CLIFTON AVE, #200
WICHITA, KS 67218

Sedgwick County (316) 618-1515

WICHITA ENDOCRINOLOGY, LLC

Clinic/Center

1515 S CLIFTON AVE, SUITE 103
WICHITA, KS 67218

Sedgwick County (316) 777-6404

HEART VIEWS LLC

Radiology (Diagnostic Radiology)

1515 S CLIFTON AVE, STE 320
WICHITA, KS 67218

Sedgwick County (316) 262-3444

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 John Provenzano's NPI number?

The NPI number for John Provenzano is 1710955430. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Where is John Provenzano located?

John Provenzano practices at 1515 S Clifton Ave Suite 120, Wichita, KS 67218. The listed phone number is (316) 681-3757.

What is John Provenzano's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does John Provenzano 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 11 other insurers list John Provenzano 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 John Provenzano was last updated on October 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.