Provider Demographics
NPI:1043699853
Name:KATHRYN N STANLEY DDS CHARTERED
Entity type:Organization
Organization Name:KATHRYN N STANLEY DDS CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-345-0331
Mailing Address - Street 1:8575 W 110TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1868
Mailing Address - Country:US
Mailing Address - Phone:913-345-0331
Mailing Address - Fax:
Practice Address - Street 1:8575 W 110TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1868
Practice Address - Country:US
Practice Address - Phone:913-345-0331
Practice Address - Fax:913-345-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60472261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental