Provider Demographics
NPI:1992956486
Name:DOUGLAS J. SJOGREN, D.D.S., P.A.
Entity type:Organization
Organization Name:DOUGLAS J. SJOGREN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:STONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-469-8019
Mailing Address - Street 1:13772 S BLACKBOB RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1932
Mailing Address - Country:US
Mailing Address - Phone:913-469-8019
Mailing Address - Fax:913-469-1462
Practice Address - Street 1:13772 S BLACKBOB RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1932
Practice Address - Country:US
Practice Address - Phone:913-469-8019
Practice Address - Fax:913-469-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty