Provider Demographics
NPI:1477606762
Name:LENZ, MATTHEW T (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:T
Last Name:LENZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14221 METCALF AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3367
Mailing Address - Country:US
Mailing Address - Phone:913-851-5900
Mailing Address - Fax:913-851-5912
Practice Address - Street 1:14221 METCALF AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3367
Practice Address - Country:US
Practice Address - Phone:913-851-5900
Practice Address - Fax:913-851-5912
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60364122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist