Provider Demographics
NPI:1538759410
Name:SUTTON FAMILY DENTISTRY OP, LLC
Entity type:Organization
Organization Name:SUTTON FAMILY DENTISTRY OP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-309-2287
Mailing Address - Street 1:11400 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-2003
Mailing Address - Country:US
Mailing Address - Phone:816-309-2287
Mailing Address - Fax:
Practice Address - Street 1:5255 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-3201
Practice Address - Country:US
Practice Address - Phone:816-309-2287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty