Provider Demographics
NPI:1427742717
Name:UBERROTH, DDS, TIFFANI A (DDS)
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:A
Last Name:UBERROTH, DDS
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 1:1730 SW STATE ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-3947
Mailing Address - Country:US
Mailing Address - Phone:816-228-8400
Mailing Address - Fax:816-396-8529
Practice Address - Street 1:1730 SW STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-3947
Practice Address - Country:US
Practice Address - Phone:816-228-8400
Practice Address - Fax:816-396-8529
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230204511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice