Provider Demographics
NPI:1386633071
Name:SAENGSAMRAN LAVID, PIENGJAI JOY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PIENGJAI
Middle Name:JOY
Last Name:SAENGSAMRAN LAVID
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 1:14516 HOWE DR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-3670
Mailing Address - Country:US
Mailing Address - Phone:913-681-5384
Mailing Address - Fax:
Practice Address - Street 1:1286 W FOXWOOD DR
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8300
Practice Address - Country:US
Practice Address - Phone:816-331-1144
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0161371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice