Provider Demographics
NPI:1194467506
Name:HOFFMEISTER, HEATH (DDS)
Entity Type:Individual
Prefix:
First Name:HEATH
Middle Name:
Last Name:HOFFMEISTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 HARDY ST APT 14301
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-7816
Mailing Address - Country:US
Mailing Address - Phone:620-205-6588
Mailing Address - Fax:
Practice Address - Street 1:204 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1315
Practice Address - Country:US
Practice Address - Phone:913-856-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program