# VILLAGE DENTAL GLADSTONE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Village Dental- North KC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316717283
- **Authorized official:** NELSON KANNING DDS (OWNER)
- **Authorized official phone:** (913) 515-3359

## Contact information

- **Practice address:** 4104 NE VIVION RD, KANSAS CITY, MO 64119-2811
- **Practice address phone:** (816) 452-8700
- **Mailing address:** 4104 NE VIVION RD, KANSAS CITY, MO 64119-2811
- **Mailing address phone:** (816) 452-8700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2024
- **Last updated:** 06/10/2026