Provider Demographics
NPI:1467299362
Name:EARLE, ELIZABETH KIEFNER (DDS)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KIEFNER
Last Name:EARLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:KIEFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2838 N OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-2983
Mailing Address - Country:US
Mailing Address - Phone:316-978-8350
Mailing Address - Fax:
Practice Address - Street 1:196 S MCCLEARY RD
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-8456
Practice Address - Country:US
Practice Address - Phone:816-630-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250211871223G0001X
KS621351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice