Provider Demographics
NPI:1952599797
Name:DUEDE, BRENDAN LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:LEE
Last Name:DUEDE
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 1:12201 BRIAR DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1520
Mailing Address - Country:US
Mailing Address - Phone:816-304-0185
Mailing Address - Fax:
Practice Address - Street 1:13025 S MUR LEN RD STE 250
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5452
Practice Address - Country:US
Practice Address - Phone:913-764-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA564071223G0001X
MO20070210611223G0001X
KS605971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice