# PARKLANE DENTAL PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Adventure Dental and Vision
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528424702
- **Authorized official:** SHAUN URBANOZO (CREDENTIALING MANAGER)
- **Authorized official phone:** (719) 323-2362

## Contact information

- **Practice address:** 980 S OLIVER ST, WICHITA, KS 97218-3216
- **Practice address phone:** (316) 221-3008
- **Practice address fax:** (316) 221-3015
- **Mailing address:** 2221 E BIJOU ST, STE 100, COLORADO SPRINGS, CO 80909-8009
- **Mailing address phone:** (719) 955-8896
- **Mailing address fax:** (719) 955-3470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 61154 | KS | — |
| 1223G0001X | General Practice Dentistry | — | KS | Yes |

## Other

- **Enumeration date:** 01/04/2016
- **Last updated:** 09/09/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 61154 | KANSAS DENTAL BOARD LICENSE NUMBER | KS |