Provider Demographics
NPI:1578009361
Name:BDNEWELL DDS LLC
Entity Type:Organization
Organization Name:BDNEWELL DDS LLC
Other - Org Name:FAMILY & IMPLANT DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-233-1162
Mailing Address - Street 1:2301 SW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1759
Mailing Address - Country:US
Mailing Address - Phone:785-233-1162
Mailing Address - Fax:785-233-4169
Practice Address - Street 1:2301 SW 6TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1759
Practice Address - Country:US
Practice Address - Phone:785-233-1162
Practice Address - Fax:785-233-4169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS613041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty