Provider Demographics
NPI:1710109418
Name:MICHAEL E MICHEL D D S P A
Entity Type:Organization
Organization Name:MICHAEL E MICHEL D D S P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-273-0801
Mailing Address - Street 1:3033 SW VILLA WEST DR STE B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-4488
Mailing Address - Country:US
Mailing Address - Phone:785-273-0801
Mailing Address - Fax:785-273-7350
Practice Address - Street 1:3033 SW VILLA WEST DR STE B
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4488
Practice Address - Country:US
Practice Address - Phone:785-273-0801
Practice Address - Fax:785-273-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS57521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7023350001Medicare NSC