# JOHNSON COUNTY DENTAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417133521
- **Authorized official:** LISA A THURLOW D.D.S. (DENTIST)
- **Authorized official phone:** (913) 341-7440

## Contact information

- **Practice address:** 5329 W 94TH TER, PRAIRIE VILLAGE, KS 66207-2503
- **Practice address phone:** (913) 341-7440
- **Practice address fax:** (913) 341-6220
- **Mailing address:** 5329 W 94TH TER, PRAIRIE VILLAGE, KS 66207-2503
- **Mailing address phone:** (913) 341-7440
- **Mailing address fax:** (913) 341-6220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6925 | KS | Yes |

## Other

- **Enumeration date:** 01/18/2008
- **Last updated:** 01/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 21597040 | BC/BS OF KANSAS CITY | KS |
| 01 | — | 23327037 | BC/BS OF KANSAS CITY | KS |
| 01 | — | 449032 | BC/BS OF KANSAS | KS |
| 01 | — | 449033 | BC/BS OF KANSAS | KS |
| 01 | — | 479134 | BC/BS OF KANSAS | KS |