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

Country Club Dental PA

Organization General Practice Dentistry · NPI 1699137109

Country Club Dental PA is a General Practice Dentistry in Topeka, Kansas. Licensed in Kansas. Registered with an NPI since 2016.

Licensed in
KS
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

400 SW 29th St Ste M
Topeka, KS 66611-1164
Phone: (785) 783-5981
Fax: (785) 783-5982
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X (KS)
General Practice Dentistry Taxonomy 1223G0001X

Record details

NPI number1699137109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shaun Urbanozo — Credentialing Manager · (719) 323-2362
Other names Adventure Dental And Vision; Adventure Dental And Vision
NPI enumeratedMarch 23, 2016
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025
Mailing address2221 E Bijou St, Ste 100, Colorado Springs, CO 80909-8009

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