Provider Demographics
NPI:1407978232
Name:SATHEESH, KEERTHANA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEERTHANA
Middle Name:M
Last Name:SATHEESH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10870 BENSON ST
Mailing Address - Street 2:BLDG. 21 SUITE 2100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1502
Mailing Address - Country:US
Mailing Address - Phone:913-451-6158
Mailing Address - Fax:913-451-9463
Practice Address - Street 1:10870 BENSON ST
Practice Address - Street 2:BLDG. 21 SUITE 2100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1502
Practice Address - Country:US
Practice Address - Phone:913-451-6158
Practice Address - Fax:913-451-9463
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS603381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics