Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Adult and Pediatric Dermatology

Organization Dermatology Physician · NPI 1609966753

Adult and Pediatric Dermatology is a Dermatology Physician in Overland Park, Kansas. Licensed in Kansas. Registered with an NPI since 2006.

Licensed in
KS
In the registry since
2006

Practice location Address checks out

4601 W 109th St Ste 116
Overland Park, KS 66211-1313
Phone: (913) 469-1115
Fax: (913) 469-9192
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 0422209 (KS)

Record details

NPI number1609966753
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jenean Kemp — Administrator · (913) 948-9184
NPI enumeratedOctober 12, 2006
Last updated in NPPESJuly 13, 2022
Certification dateJuly 13, 2022
Mailing address4601 W. 109th Street, Suite 116, Overland Park, KS 66211-1313

Other providers in Overland Park