Provider Demographics
NPI:1861901639
Name:PHYE FAMILY DENTISTRY, P.A.
Entity type:Organization
Organization Name:PHYE FAMILY DENTISTRY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RESZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, BS
Authorized Official - Phone:913-782-2231
Mailing Address - Street 1:401 S CLAIRBORNE RD STE A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1735
Mailing Address - Country:US
Mailing Address - Phone:913-782-2231
Mailing Address - Fax:913-782-2246
Practice Address - Street 1:401 S. CLAIRBORNE
Practice Address - Street 2:SUITE A
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062
Practice Address - Country:US
Practice Address - Phone:913-782-2231
Practice Address - Fax:913-782-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7126122300000X
KS60308122300000X
KS60739122300000X
332BC3200X
KS6899122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty