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

Prime Healthcare Physician Services - Providence Inc

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1356683213

Prime Healthcare Physician Services - Providence Inc is an Oral & Maxillofacial Surgery (D.M.D.) in Shawnee, Kansas. Works from 19 locations. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
14
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

16663 Midland Dr Ste 100
Shawnee, KS 66217-3042
Phone: (913) 631-2600
Fax: (913) 631-2606
Show map & directions

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

Additional practice locations (18)

  • 15604 Pinehurst Dr Ste 2, Basehor, KS 66007-8234 — (913) 728-2200
  • 913 Sheidley Ave, Bonner Springs, KS 66012-9514 — (913) 322-7222
  • 8101 Parallel Pkwy Ste 100, Kansas City, KS 66112-2067 — (913) 299-9200
  • 8919 Parallel Pkwy Ste 206, Kansas City, KS 66112-1655 — (913) 334-6800
  • 8919 Parallel Pkwy Ste 416, Kansas City, KS 66112-1655 — (913) 596-5104
  • 8919 Parallel Pkwy Ste 121, Kansas City, KS 66112-1655 — (913) 596-7230
  • 8929 Parallel Pkwy, Kansas City, KS 66112-1689 — (913) 596-3930
  • 8919 Parallel Pkwy Ste 455, Kansas City, KS 66112-3628 — (913) 596-4929
  • 8919 Parallel Pkwy Ste 440, Kansas City, KS 66112-1655 — (913) 596-7286
  • 1420 S 42nd St, Kansas City, KS 66106-1952 — (913) 831-1100
  • 8919 Parallel Pkwy Ste 580, Kansas City, KS 66112-1655 — (913) 596-7224
  • 8919 Parallel Pkwy Ste 555, Kansas City, KS 66112-3628 — (913) 596-3940
  • 3550 S 4th St Ste 200, Leavenworth, KS 66048-5009 — (913) 680-6442
  • 3500 S 4th St, Leavenworth, KS 66048-5043 — (913) 680-6000
  • 3550 S 4th St Ste 115, Leavenworth, KS 66048-5061 — (913) 596-7224
  • 3550 S 4th Street, Leavenworth, KS 66048 — (913) 680-6000
  • 7255 Renner Rd, Shawnee, KS 66217-3043 — (913) 334-6800
  • 7230 Renner Rd, Shawnee, KS 66217-9901 — (913) 962-2122

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X
Anesthesiology Physician Taxonomy 207L00000X
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Gastroenterology Physician Taxonomy 207RG0100X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician Taxonomy 207VF0040X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician Taxonomy 2083P0011X
Neurology Physician Taxonomy 2084N0400X
Surgery Physician Taxonomy 208600000X
Pediatric Surgery Physician Taxonomy 2086S0120X

Record details

NPI number1356683213
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationPrime Healthcare Services, Inc
Authorized official Christopher Doan — Managing Associate General Counsel · (310) 259-4706
Other names Providence Medical Group
NPI enumeratedMarch 19, 2013
Last updated in NPPESAugust 25, 2025
Certification dateAugust 25, 2025
Mailing address8929 Parallel Pkwy, Kansas City, KS 66112-1689