Provider Demographics
NPI:1831941707
Name:HANNAH INGRAM DDS LLC
Entity type:Organization
Organization Name:HANNAH INGRAM DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:660-281-3093
Mailing Address - Street 1:192 E 25TH AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3077
Mailing Address - Country:US
Mailing Address - Phone:660-281-3093
Mailing Address - Fax:
Practice Address - Street 1:19501 E US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5475
Practice Address - Country:US
Practice Address - Phone:816-795-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental