Provider Demographics
NPI:1013003284
Name:HIGGINS, SUE E (DDS)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:E
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:E
Other - Last Name:JOHNSON HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:609 NE 291 HWY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086
Mailing Address - Country:US
Mailing Address - Phone:816-525-7100
Mailing Address - Fax:816-525-7167
Practice Address - Street 1:609 NE 291 HWY
Practice Address - Street 2:SUITE 360
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086
Practice Address - Country:US
Practice Address - Phone:816-525-7100
Practice Address - Fax:816-525-7167
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODEN014179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist