Provider Demographics
NPI:1437221983
Name:S&G FAMILY DENTISTRY, P.A.
Entity Type:Organization
Organization Name:S&G FAMILY DENTISTRY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHOPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-451-2929
Mailing Address - Street 1:11313 ASH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1643
Mailing Address - Country:US
Mailing Address - Phone:913-451-2929
Mailing Address - Fax:913-451-2959
Practice Address - Street 1:11313 ASH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1643
Practice Address - Country:US
Practice Address - Phone:913-451-2929
Practice Address - Fax:913-451-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS59601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1OtherLYNNE M. SCHOPPER, D.D.S.
KS1962419127OtherDR. NANCY ADDY
KS2OtherJARRETT S. GROSDIDIER, D.