Provider Demographics
NPI:1235101031
Name:ECKENBERG, ROBERT N (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:ECKENBERG
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 1:14000 GARNETT ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-2806
Mailing Address - Country:US
Mailing Address - Phone:913-681-1250
Mailing Address - Fax:913-681-1299
Practice Address - Street 1:15431 ANDREWS RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64147-1221
Practice Address - Country:US
Practice Address - Phone:816-843-3670
Practice Address - Fax:816-843-3673
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0133111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice