Provider Demographics
NPI:1770576795
Name:KLAASSEN, LELAND WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:LELAND
Middle Name:WAYNE
Last Name:KLAASSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:407 S CLAIRBORNE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1723
Mailing Address - Country:US
Mailing Address - Phone:913-782-1335
Mailing Address - Fax:913-782-0062
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1723
Practice Address - Country:US
Practice Address - Phone:913-782-1335
Practice Address - Fax:913-782-0062
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist