# MY DENTIST WICHITA, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MY DENTIST WICHITA, PA
- **Other names:** Wheatland Family Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467872325
- **Legal business name:** MY DENTIST WICHITA, PA
- **Authorized official:** KENDRA WALKER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-8312

## Contact information

- **Practice address:** 1443 N ROCK RD, WICHITA, KS 67206-1245
- **Practice address phone:** (316) 295-2830
- **Mailing address:** 1443 N ROCK RD, WICHITA, KS 67206-1245

## Taxonomy

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

## Other

- **Enumeration date:** 04/18/2014
- **Last updated:** 10/27/2015