1245469550 NPI number — DR. MARIA DEL CIELO BARRAGAN DDS

Table of content: DR. MARIA DEL CIELO BARRAGAN DDS (NPI 1245469550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245469550 NPI number — DR. MARIA DEL CIELO BARRAGAN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRAGAN
Provider First Name:
MARIA
Provider Middle Name:
DEL CIELO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADJEMIAN
Provider Other First Name:
MARIA
Provider Other Middle Name:
DEL CIELO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245469550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5713 NW 64TH TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64151-2382
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4720 RAINBOW BLVD STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTWOOD
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66205-1863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-9200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2009017290 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 61302 . This is a "DENTAL LICENSE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".