Provider Demographics
NPI:1891886859
Name:HERRE, SCOTT BRYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BRYAN
Last Name:HERRE
Suffix:
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 1:11201 NALL AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1669
Mailing Address - Country:US
Mailing Address - Phone:913-491-4466
Mailing Address - Fax:913-469-1797
Practice Address - Street 1:11237 NALL AVE STE 140
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1639
Practice Address - Country:US
Practice Address - Phone:913-913-7341
Practice Address - Fax:913-912-7343
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6485122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist