Provider Demographics
NPI:1316169485
Name:WENBURG, CHRIS EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:EUGENE
Last Name:WENBURG
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 1:608 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2313
Mailing Address - Country:US
Mailing Address - Phone:970-426-1982
Mailing Address - Fax:
Practice Address - Street 1:4320 WORNALL RD STE 500
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3235
Practice Address - Country:US
Practice Address - Phone:816-561-4555
Practice Address - Fax:816-561-3574
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200057971223G0001X
CO9893122300000X
NE6658122300000X
MO2006015458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist