Provider Demographics
NPI:1255370649
Name:PIERCE & KNIGHT FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:PIERCE & KNIGHT FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-888-2882
Mailing Address - Street 1:8615 ROSEHILL RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2867
Mailing Address - Country:US
Mailing Address - Phone:913-888-2882
Mailing Address - Fax:913-888-2858
Practice Address - Street 1:8615 ROSEHILL RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2867
Practice Address - Country:US
Practice Address - Phone:913-888-2882
Practice Address - Fax:913-888-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS51501223G0001X
KS606961223G0001X
KS601921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS028954OtherBLUE CROSS BLUE SHIELD KS
MO34516014OtherBLUE CROSS BLUE SHIELD KC
KS794482OtherUNITED CONCORDIA
MO01452024OtherBLUE CROSS BLUE SHIELD KC