Provider Demographics
NPI:1033297387
Name:KESSLER, SUSAN KEIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:KEIL
Last Name:KESSLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 W 83RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5300
Mailing Address - Country:US
Mailing Address - Phone:913-385-2324
Mailing Address - Fax:913-648-8645
Practice Address - Street 1:4121 W 83RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5300
Practice Address - Country:US
Practice Address - Phone:913-385-2324
Practice Address - Fax:913-648-8645
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60632122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1223G0001XOtherTAXONOMY #