Individual
DR. MICHAEL BASHOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
20168 W 153RD ST, OLATHE, KS 66062-9131
(913) 839-9709
Mailing address
20168 W 153RD ST, OLATHE, KS 66062-9131
(913) 839-9709
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2017019368
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
62076
KS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2017019368
MO
Other
Enumeration date
06/24/2017
Last updated
08/22/2025
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