Provider Demographics
NPI:1487628053
Name:DRAKE, EMILY CLARE BARTELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:CLARE BARTELL
Last Name:DRAKE
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 1:3801 SOUTHWEST TRFY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2902
Mailing Address - Country:US
Mailing Address - Phone:816-622-2000
Mailing Address - Fax:
Practice Address - Street 1:3801 SOUTHWEST TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2902
Practice Address - Country:US
Practice Address - Phone:816-622-2000
Practice Address - Fax:816-298-9214
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110173451223P0221X
NE6537122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty