Provider Demographics
NPI:1699854752
Name:KRAUSE, KEVIN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JOSEPH
Last Name:KRAUSE
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 1:9401 NALL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2515
Mailing Address - Country:US
Mailing Address - Phone:913-642-7272
Mailing Address - Fax:913-642-4434
Practice Address - Street 1:9401 NALL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-2515
Practice Address - Country:US
Practice Address - Phone:913-642-7272
Practice Address - Fax:913-642-4434
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6650122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist