Provider Demographics
NPI:1144414400
Name:NEWHOUSE, NANCY L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4731 S COCHISE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6975
Mailing Address - Country:US
Mailing Address - Phone:816-373-6800
Mailing Address - Fax:816-373-6832
Practice Address - Street 1:4731 S COCHISE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6975
Practice Address - Country:US
Practice Address - Phone:816-373-6800
Practice Address - Fax:816-373-6832
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0133371223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics