Provider Demographics
NPI:1598797243
Name:HINRICHS, COREY JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:JAMES
Last Name:HINRICHS
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 1:12080 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-8136
Mailing Address - Country:US
Mailing Address - Phone:913-814-7400
Mailing Address - Fax:913-814-8555
Practice Address - Street 1:12080 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-8136
Practice Address - Country:US
Practice Address - Phone:913-814-7400
Practice Address - Fax:913-814-8555
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS65671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice