Provider Demographics
NPI:1013111061
Name:SCHUTTE, ROBERTA LYNNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:LYNNE
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LYNNE
Other - Middle Name:
Other - Last Name:SCHUTTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1010 CARONDELET DR STE 222
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 CARONDELET DR STE 222
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4822
Practice Address - Country:US
Practice Address - Phone:816-942-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO13961122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist