| Vibrant Health - Dental | |
|
21 N 12th St Ste 201 Kansas City KS 66102-5172 | |
| (913) 342-2552 | |
| (913) 342-3220 |
| Full Name | Vibrant Health - Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 N 12th St Ste 201, Kansas City, Kansas |
| Authorized Official Name and Position | Patrick Sallee (CEO) |
| Authorized Official Contact | 9133202607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Health - Dental 21 N 12th St Ste 300 Kansas City KS 66102-5105 Ph: (913) 342-2552 | Vibrant Health - Dental 21 N 12th St Ste 201 Kansas City KS 66102-5172 Ph: (913) 342-2552 |
| NPI Number | 1780256891 |
|---|---|
| Provider Enumeration Date | 07/16/2021 |
| Last Update Date | 09/03/2021 |
| Medicare PECOS PAC ID | 9739447921 |
|---|---|
| Medicare Enrollment ID | O20211029000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780256891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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