# ANDREW VAN BLARCOM, DDS, PA

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

## Provider details

- **NPI number:** 1831301340
- **Authorized official:** DR. ANDREW BLAKE VAN BLARCOM D.D.S. (PRESIDENT)
- **Authorized official phone:** (913) 649-4946

## Contact information

- **Practice address:** 5000 WEST 95TH STREET, SUITE NUMBER 290, PRAIRIE VILLAGE, KS 66207
- **Practice address phone:** (913) 649-4946
- **Practice address fax:** (913) 649-2460
- **Mailing address:** 5000 WEST 95TH STREET, SUITE NUMBER 290, PRAIRIE VILLAGE, KS 66207
- **Mailing address phone:** (913) 649-4946
- **Mailing address fax:** (913) 649-2460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 60277 | KS | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/22/2020