Provider Demographics
NPI:1942660527
Name:SANDER, KRISTEN MW (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MW
Last Name:SANDER
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14894 S SYMPHONY DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3342
Mailing Address - Country:US
Mailing Address - Phone:316-706-9799
Mailing Address - Fax:
Practice Address - Street 1:6804 SILVERHEEL ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-5300
Practice Address - Country:US
Practice Address - Phone:913-962-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS610281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics