| Independence Pediatric Dentistry LLC | |
|
651 E 24 Hwy Independence MO 64050-2974 | |
| (816) 461-3661 | |
| (913) 210-2224 |
| Full Name | Independence Pediatric Dentistry LLC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 651 E 24 Hwy, Independence, Missouri |
| Authorized Official Name and Position | Shayna Bahr (MANAGER) |
| Authorized Official Contact | 8164613661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Pediatric Dentistry LLC 10975 Grandview Dr Ste 350 Overland Park KS 66210-1522 | Independence Pediatric Dentistry LLC 651 E 24 Hwy Independence MO 64050-2974 Ph: (816) 461-3661 |
| NPI Number | 1376058420 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 03/25/2026 |
| Certification Date | 03/25/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376058420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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