Provider Demographics
NPI:1649254350
Name:WINBURN, RICHARD LARRY (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LARRY
Last Name:WINBURN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10351 MASTIN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5452
Mailing Address - Country:US
Mailing Address - Phone:913-492-5180
Mailing Address - Fax:913-492-0338
Practice Address - Street 1:10351 MASTIN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5452
Practice Address - Country:US
Practice Address - Phone:913-492-5180
Practice Address - Fax:913-492-0338
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS600621223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health