Provider Demographics
NPI:1568628386
Name:DANIEL C NIELSON DDS CHARTERED
Entity Type:Organization
Organization Name:DANIEL C NIELSON DDS CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANEIL
Authorized Official - Middle Name:C
Authorized Official - Last Name:NIELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-829-8700
Mailing Address - Street 1:16500 W INDIAN CREEK PKWY
Mailing Address - Street 2:100
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062
Mailing Address - Country:US
Mailing Address - Phone:913-829-8700
Mailing Address - Fax:913-829-8709
Practice Address - Street 1:16500 INDIAN CREEK PKWY
Practice Address - Street 2:100
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1370
Practice Address - Country:US
Practice Address - Phone:913-829-8700
Practice Address - Fax:913-829-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60141122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty