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

Leavenworth Oral & Maxillofacial Surgeons PA

Organization Oral and Maxillofacial Pathology Dentistry · NPI 1609841493

Leavenworth Oral & Maxillofacial Surgeons PA is an Oral and Maxillofacial Pathology Dentistry in Leavenworth, Kansas. Licensed in Kansas. Registered with an NPI since 2006.

Licensed in
KS
In the registry since
2006
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

3550 S 4th St Ste 240
Leavenworth, KS 66048-5071
Phone: (913) 772-4334
Fax: (913) 772-0851
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X · Licence 4672 (KS)

Record details

NPI number1609841493
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larry Evans — President · (913) 772-4334
NPI enumeratedFebruary 23, 2006
Last updated in NPPESAugust 22, 2020
Mailing address3550 S 4th St, Suite 240, Leavenworth, KS 66048-5071

Other providers in Leavenworth