Provider Demographics
NPI:1811980469
Name:COOKSON & HANSEN, DDS, PC
Entity type:Organization
Organization Name:COOKSON & HANSEN, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MRG
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-452-0300
Mailing Address - Street 1:6301 N OAK TRFY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4705
Mailing Address - Country:US
Mailing Address - Phone:816-452-0300
Mailing Address - Fax:816-452-3385
Practice Address - Street 1:6301 N OAK TRFY
Practice Address - Street 2:SUITE 101
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4705
Practice Address - Country:US
Practice Address - Phone:816-452-0300
Practice Address - Fax:816-452-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO22814021OtherBCBS
MOL370000OtherMEDICARE RAILROAD