| Organization Name: | KC CONE BEAM, L.L.C. |
| NPI Number: | 1073928495 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN P. CUNNINGHAM (OWNER) |
| Mailing Address: | 11900 W 87th Street Pkwy Suite 128 Lenexa |
| State: | KS US |
| Postal Code: | 662152807 |
| Phone Number: | 9135992228 |
| Fax Number: | 9135992229 |
| NPI Enumeration Date: | 06/24/2014 |
| NPI Last Update Date: | 06/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223X0008X |
| License Number: | BL13-00155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Oral and Maxillofacial Radiology |
| Taxonomy Definition: | The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. |