Provider Demographics
NPI:1639748627
Name:KUHNERT, TANNA BLAIR (DMD)
Entity Type:Individual
Prefix:
First Name:TANNA
Middle Name:BLAIR
Last Name:KUHNERT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 160TH RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:KS
Mailing Address - Zip Code:66017-4087
Mailing Address - Country:US
Mailing Address - Phone:816-262-6299
Mailing Address - Fax:
Practice Address - Street 1:2618 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2003
Practice Address - Country:US
Practice Address - Phone:816-364-6467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS618861223G0001X
MO20210213681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice