Provider Demographics
NPI:1033269436
Name:MORNINGSTAR FAMILY DENTAL,P.A.
Entity Type:Organization
Organization Name:MORNINGSTAR FAMILY DENTAL,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:LUCERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-344-9990
Mailing Address - Street 1:7000 W 121ST ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2008
Mailing Address - Country:US
Mailing Address - Phone:913-344-9990
Mailing Address - Fax:913-344-9991
Practice Address - Street 1:7000 W 121ST ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2008
Practice Address - Country:US
Practice Address - Phone:913-344-9990
Practice Address - Fax:913-344-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS602961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty