Basic Information
| Provider Information | |||||||||
| NPI: | 1356556542 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VILORIA | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 13316 METCALF AVE | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662132804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138515110 | ||||||||
| FaxNumber: | 9138510321 | ||||||||
| Practice Location | |||||||||
| Address1: | 13316 METCALF AVE | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662132804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138515110 | ||||||||
| FaxNumber: | 9138510321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2007 | ||||||||
| LastUpdateDate: | 05/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 05/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 2003014152 | MO | N | Dental Providers | Dentist | General Practice | 1223G0001X | 61105 | KS | Y | Dental Providers | Dentist | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 61105 | 01 | KS | KANSAS DENTAL BOARD | OTHER | 2003014152 | 01 | MO | STATE DENTAL LICENSE | OTHER |