Provider Demographics
NPI:1720064892
Name:FLOOD, ERIN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:P
Last Name:FLOOD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:P
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7301 MISSION RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3031
Mailing Address - Country:US
Mailing Address - Phone:913-362-7320
Mailing Address - Fax:913-362-8733
Practice Address - Street 1:7301 MISSION RD STE 203
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3031
Practice Address - Country:US
Practice Address - Phone:913-362-7320
Practice Address - Fax:913-362-8733
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001013729122300000X
KS604431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO405356205Medicaid