Provider Demographics
NPI:1285939777
Name:EMILY KATHERINE HANDLEY.
Entity type:Organization
Organization Name:EMILY KATHERINE HANDLEY.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF DENTAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-753-1237
Mailing Address - Street 1:PO BOX 702620
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74170-2620
Mailing Address - Country:US
Mailing Address - Phone:405-751-7131
Mailing Address - Fax:405-751-7160
Practice Address - Street 1:14227 E HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64136-1187
Practice Address - Country:US
Practice Address - Phone:405-751-7131
Practice Address - Fax:405-751-7160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MY DENTIST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-14
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO015684305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization