Provider Demographics
NPI:1417948027
Name:BEHRENS, DEEANN RICHARDS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEEANN
Middle Name:RICHARDS
Last Name:BEHRENS
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 1:6420 PARALLEL AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1043
Mailing Address - Country:US
Mailing Address - Phone:913-299-6699
Mailing Address - Fax:913-299-2256
Practice Address - Street 1:6420 PARALLEL AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1043
Practice Address - Country:US
Practice Address - Phone:913-299-6699
Practice Address - Fax:913-299-2256
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4054863701Medicare ID - Type Unspecified