Provider Demographics
NPI:1619356326
Name:BRIANNA GANSON, DDS, LLC
Entity Type:Organization
Organization Name:BRIANNA GANSON, DDS, LLC
Other - Org Name:HAPPY TEETH DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, LLC
Authorized Official - Phone:913-569-6555
Mailing Address - Street 1:11225 NALL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11225 NALL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1636
Practice Address - Country:US
Practice Address - Phone:913-469-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO608291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty