Provider Demographics
NPI:1417153305
Name:RICHARD L. WINBURN, DDS P.A.
Entity Type:Organization
Organization Name:RICHARD L. WINBURN, DDS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:WINBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-492-5180
Mailing Address - Street 1:10351 MASTIN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5452
Mailing Address - Country:US
Mailing Address - Phone:913-492-5180
Mailing Address - Fax:913-492-0338
Practice Address - Street 1:10351 MASTIN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5452
Practice Address - Country:US
Practice Address - Phone:913-492-5180
Practice Address - Fax:913-492-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS600621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty