Provider Demographics
NPI:1245217801
Name:SIMONET, WHITNEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:
Last Name:SIMONET
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6708 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-3021
Mailing Address - Country:US
Mailing Address - Phone:913-299-8554
Mailing Address - Fax:913-299-3187
Practice Address - Street 1:6708 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-3021
Practice Address - Country:US
Practice Address - Phone:913-299-8554
Practice Address - Fax:913-299-3187
Is Sole Proprietor?:No
Enumeration Date:2005-12-26
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60106122300000X
MO2011036173122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100406010BMedicaid
KS1005260OtherDORAL
KS1245217801OtherMEDICAID/SCION DENTAL/SUNFLOWER/UNITED HEALTHCARE