# VILLAGE DENTAL, LLC

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

## Provider details

- **NPI number:** 1417552464
- **Authorized official:** AMY D KANNING (BUSINESS MANAGER)
- **Authorized official phone:** (913) 908-9523

## Contact information

- **Practice address:** 415 E US HIGHWAY 69, KANSAS CITY, MO 64119-3118
- **Practice address phone:** (816) 580-4191
- **Mailing address:** 415 E US HIGHWAY 69, KANSAS CITY, MO 64119-3118
- **Mailing address phone:** (816) 263-3900

## 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:** 11/30/2020
- **Last updated:** 06/10/2026