Provider Demographics
NPI:1982731543
Name:DYER-CHENOWETH, DIANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:DYER-CHENOWETH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 MISSION RD STE N11
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4282
Mailing Address - Country:US
Mailing Address - Phone:913-383-9338
Mailing Address - Fax:913-383-8505
Practice Address - Street 1:7501 MISSION RD STE N11
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4282
Practice Address - Country:US
Practice Address - Phone:913-383-9338
Practice Address - Fax:913-383-8505
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist