Provider Demographics
NPI:1932302023
Name:VAN BIBER DENTISTRY LLC
Entity Type:Organization
Organization Name:VAN BIBER DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:VAN BIBER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-350-0350
Mailing Address - Street 1:13665 E 42ND TER
Mailing Address - Street 2:SUITE G
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-7343
Mailing Address - Country:US
Mailing Address - Phone:816-350-0350
Mailing Address - Fax:816-350-0352
Practice Address - Street 1:3313 S SEMINOLE CT
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2770
Practice Address - Country:US
Practice Address - Phone:816-795-9910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty