Provider Demographics
NPI:1649623190
Name:SCHOWENGERDT, BRIAN CHRISTOPHER I (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:SCHOWENGERDT
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 ROE AVENUE #200
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205
Mailing Address - Country:US
Mailing Address - Phone:913-432-8700
Mailing Address - Fax:
Practice Address - Street 1:5930 ROE AVE STE 200
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205-3062
Practice Address - Country:US
Practice Address - Phone:913-432-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist