Provider Demographics
NPI:1205199981
Name:PRINGLE, REBECCA WEBSTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:WEBSTER
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:WEBSTER
Other - Last Name:PARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6943 W 37TH ST N
Mailing Address - Street 2:CHILDREN'S DENTAL PROFESSIONALS LLC
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-9302
Mailing Address - Country:US
Mailing Address - Phone:316-613-2077
Mailing Address - Fax:
Practice Address - Street 1:6943 W 37TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-9302
Practice Address - Country:US
Practice Address - Phone:316-613-2077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9430122300000X
KS61298122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201164480AMedicaid