Provider Demographics
NPI:1598935710
Name:ALEX HEYDAR MOTAREF DMD PC
Entity Type:Organization
Organization Name:ALEX HEYDAR MOTAREF DMD PC
Other - Org Name:DENTAL CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:HEYDAR
Authorized Official - Last Name:MOTAREF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:816-763-3030
Mailing Address - Street 1:6406 E 87TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138
Mailing Address - Country:US
Mailing Address - Phone:816-763-3030
Mailing Address - Fax:816-965-9948
Practice Address - Street 1:6406 E 87TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138
Practice Address - Country:US
Practice Address - Phone:816-763-3030
Practice Address - Fax:816-965-9948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO158101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty