Provider Demographics
NPI:1871790618
Name:MARKER, KRISTY LIND (DDS, MS)
Entity type:Individual
Prefix:MISS
First Name:KRISTY
Middle Name:LIND
Last Name:MARKER
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 CENTRAL ST. #205
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112
Mailing Address - Country:US
Mailing Address - Phone:785-230-3454
Mailing Address - Fax:
Practice Address - Street 1:1731 E NORTH AVE
Practice Address - Street 2:BELTON MODERN DENTISTRY
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012
Practice Address - Country:US
Practice Address - Phone:785-215-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170213081223E0200X
IA084571223E0200X
KS600021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics