1053974139 NPI number — BLUE SPRINGS DENTAL DANIEL J TOKAR DDS PC

Table of content: (NPI 1053974139)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053974139 NPI number — BLUE SPRINGS DENTAL DANIEL J TOKAR DDS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLUE SPRINGS DENTAL DANIEL J TOKAR DDS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053974139
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5201 ROE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROELAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66205-2390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-828-0060
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
624 SW US HIGHWAY 40
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE SPRINGS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64014-3231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-988-3400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2019

Additional Information

Authorized Official

Authorized Official Last Name:
TOKAR
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
JOSHUA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
816-988-3400

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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