Provider Demographics
NPI:1962419127
Name:ADDY, NANCY L (DDS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:ADDY
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 1:11313 ASH STREET
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211
Mailing Address - Country:US
Mailing Address - Phone:913-451-2929
Mailing Address - Fax:913-451-2959
Practice Address - Street 1:11313 ASH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1643
Practice Address - Country:US
Practice Address - Phone:913-451-2929
Practice Address - Fax:913-451-2959
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice