Provider Demographics
NPI:1164195442
Name:DOAKES DENTAL SERVICES LLC
Entity Type:Organization
Organization Name:DOAKES DENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-922-9246
Mailing Address - Street 1:801 W 47TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1253
Mailing Address - Country:US
Mailing Address - Phone:816-931-2191
Mailing Address - Fax:816-931-4617
Practice Address - Street 1:1 WESTBURY DR BLDG C310
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2550
Practice Address - Country:US
Practice Address - Phone:636-723-6071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty