Basic Information
Provider Information
NPI: 1033727821
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SLENKER
FirstName: RACHEL
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13660 MAPLE ST APT 307
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662231271
CountryCode: US
TelephoneNumber: 8165172921
FaxNumber:  
Practice Location
Address1: 940 NW BLUE PKWY STE 100
Address2:  
City: LEES SUMMIT
State: MO
PostalCode: 640866074
CountryCode: US
TelephoneNumber: 8165245752
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/17/2020
LastUpdateDate: 10/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X2020022616MON Dental ProvidersDentist 
122300000X61641KSY Dental ProvidersDentist 

No ID Information.


Home