Provider Demographics
NPI:1215198759
Name:CASEY, JOANNA LYNN (DDS)
Entity Type:Individual
Prefix:MISS
First Name:JOANNA
Middle Name:LYNN
Last Name:CASEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:JOANNA
Other - Middle Name:LYNN
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:10870 BENSON DR STE 2100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1509
Mailing Address - Country:US
Mailing Address - Phone:913-541-3330
Mailing Address - Fax:913-541-3399
Practice Address - Street 1:10870 BENSON DR STE 2100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1509
Practice Address - Country:US
Practice Address - Phone:913-541-3330
Practice Address - Fax:913-541-3399
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS605651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice