Provider Demographics
NPI:1497864417
Name:REGAN, DEAUN SILVA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAUN
Middle Name:SILVA
Last Name:REGAN
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 1:407 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3737
Mailing Address - Country:US
Mailing Address - Phone:816-505-9445
Mailing Address - Fax:816-741-2125
Practice Address - Street 1:407 N. MAIN ST
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3737
Practice Address - Country:US
Practice Address - Phone:816-505-9445
Practice Address - Fax:816-741-2125
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE015723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist