Provider Demographics
NPI:1003904574
Name:SANCHEZ, JASON MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MATTHEW
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 NICHOLS RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2015
Mailing Address - Country:US
Mailing Address - Phone:816-561-0333
Mailing Address - Fax:816-561-0724
Practice Address - Street 1:411 NICHOLS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2015
Practice Address - Country:US
Practice Address - Phone:816-561-0333
Practice Address - Fax:816-561-0724
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030131041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice