Provider Demographics
NPI:1962736884
Name:LOBB, KRISTINA LYNN (RDH, BS)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LYNN
Last Name:LOBB
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LYNN
Other - Last Name:LADAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH, BS
Mailing Address - Street 1:706 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-9586
Mailing Address - Country:US
Mailing Address - Phone:913-634-0417
Mailing Address - Fax:
Practice Address - Street 1:706 RIVER ST
Practice Address - Street 2:
Practice Address - City:TONGANOXIE
Practice Address - State:KS
Practice Address - Zip Code:66086-9586
Practice Address - Country:US
Practice Address - Phone:913-634-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005015346124Q00000X
KS10594124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist