Provider Demographics
NPI:1326394834
Name:JOSHI, JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:
Last Name:JOSHI
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 1:4545 WORNALL RD APT 1101
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3258
Mailing Address - Country:US
Mailing Address - Phone:314-680-8585
Mailing Address - Fax:
Practice Address - Street 1:4545 WORNALL RD APT 1101
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3258
Practice Address - Country:US
Practice Address - Phone:314-680-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041696122300000X
NV6304122300000X
KS610971223X0400X
MO20150152041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist