Provider Demographics
NPI:1750450300
Name:HUMPHRIES, JULIA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:E
Last Name:HUMPHRIES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11680 WEDD ST
Mailing Address - Street 2:#4
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3108
Mailing Address - Country:US
Mailing Address - Phone:913-782-6533
Mailing Address - Fax:913-782-6653
Practice Address - Street 1:15095 W 123RD ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6964
Practice Address - Country:US
Practice Address - Phone:913-782-6533
Practice Address - Fax:913-782-6653
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS603841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice