# DONALD D. MARDIS, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MY DENTIST
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346585379
- **Legal business name:** MY DENTIST
- **Authorized official:** JENNIFER CHAMBERS DDS (OWNER/ MY DENTIST)
- **Authorized official phone:** (405) 286-9024

## Contact information

- **Practice address:** 7450 QUIVIRA RD, SHAWNEE MISSION, KS 66216-3526
- **Practice address phone:** (913) 217-7536
- **Practice address fax:** (913) 766-1019
- **Mailing address:** PO BOX 702620, TULSA, OK 74170-2620
- **Mailing address phone:** (405) 286-9024
- **Mailing address fax:** (405) 286-9088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 60859 | KS | Yes |

## Other

- **Enumeration date:** 12/03/2012
- **Last updated:** 06/27/2013