Provider Demographics
NPI:1871672667
Name:RETHMEYER, KAREN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:H
Last Name:RETHMEYER
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 1:702 E 97TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3243
Mailing Address - Country:US
Mailing Address - Phone:816-333-3337
Mailing Address - Fax:
Practice Address - Street 1:9225 WARD PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3336
Practice Address - Country:US
Practice Address - Phone:816-333-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE 148091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO13191011OtherBLUE CROSS BLUE SHIELD