Provider Demographics
NPI:1881937399
Name:AXELSEN, VANESSA RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:RENEE
Last Name:AXELSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:RENEE
Other - Last Name:WARZECHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7560 W 160TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8100
Mailing Address - Country:US
Mailing Address - Phone:913-232-2708
Mailing Address - Fax:913-782-1764
Practice Address - Street 1:7560 W 160TH STREET
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085-6608
Practice Address - Country:US
Practice Address - Phone:913-232-2708
Practice Address - Fax:913-232-2718
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS611341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry