Provider Demographics
NPI:1609867514
Name:LADAS, JOHN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:LADAS
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 1:2301 QUONSET CT
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-1437
Mailing Address - Country:US
Mailing Address - Phone:816-229-8049
Mailing Address - Fax:816-373-7228
Practice Address - Street 1:2301 QUONSET CT
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-1437
Practice Address - Country:US
Practice Address - Phone:816-229-8049
Practice Address - Fax:816-373-7228
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO10947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist