OLATHE PEDIATRIC DENTAL, P.A.
NPI 1902612112
Dentist - Pediatric Dentistry in Olathe, KS

Q: What is Olathe Pediatric Dental, P.A.'s NPI number?

The NPI number for Olathe Pediatric Dental, P.A. is 1902612112. It was assigned to this organization in the NPPES registry on December 4, 2024.

Q: What is Olathe Pediatric Dental, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since December 04, 2024

12708 S BLACKBOB RD STE B, OLATHE, KS 66062(913) 225-9749(913) 490-2910 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Olathe Pediatric Dental, P.a. NPPES

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

OLATHE PEDIATRIC DENTAL, P.A. (NPI 1902612112) is a healthcare organization registered as a pediatric dentistry in Olathe, Kansas and active in the NPI registry since December 2024. The organization lists Creed Cardon, President, as its authorized official.

NPPES Registry Identity

NPI1902612112

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameOLATHE PEDIATRIC DENTAL, P.A.

Location Address12708 S BLACKBOB RD STE BOlathe, KS 66062-1409

Mailing Address400 Riverwalk Ter Ste 250Jenks, OK 74037-5619 · (918) 998-0996

Phone(913) 225-9749

Fax(913) 490-2910

Organization SubpartNo

Authorized OfficialCreed CardonPresident · (918) 998-0996

Enumeration DateDecember 4, 2024

NPPES CertifiedDecember 4, 2024

✔ NPI 1902612112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

12708 S BLACKBOB RD STE B, Olathe, KS 66062

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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 SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

KANSAS KIDS DENTAL LLC

Dentist (General Practice)

12708 S BLACKBOB RD STE B
OLATHE, KS 66062

Johnson County (480) 866-8811

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 Olathe Pediatric Dental, P.A.'s NPI number?

The NPI number for Olathe Pediatric Dental, P.A. is 1902612112. It was assigned to this organization in the NPPES registry on December 4, 2024.

Where is Olathe Pediatric Dental, P.A. located?

Olathe Pediatric Dental, P.A. is located at 12708 S Blackbob Rd Ste B, Olathe, KS 66062. The listed phone number is (913) 225-9749.

What is Olathe Pediatric Dental, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Olathe Pediatric Dental, P.A. was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.