Provider Demographics
NPI:1710748793
Name:BRENDAN L DUEDE DDS LLC
Entity Type:Organization
Organization Name:BRENDAN L DUEDE DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-304-0185
Mailing Address - Street 1:12201 BRIAR DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1520
Mailing Address - Country:US
Mailing Address - Phone:816-304-0185
Mailing Address - Fax:
Practice Address - Street 1:13025 S MUR LEN RD STE 250
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5452
Practice Address - Country:US
Practice Address - Phone:913-764-1169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty