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

Dr. John R Provenzano, DDS

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1710955430

Dr. John R Provenzano, DDS is an Oral and Maxillofacial Surgery (Dentist) in Wichita, Kansas. Licensed in Kansas. Registered with an NPI since 2006.

Licensed in
KS
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1515 S Clifton Ave Ste 120
Wichita, KS 67218-2900
Phone: (316) 681-3757
Fax: (316) 652-0602
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 6557 (KS)

Record details

NPI number1710955430
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMarch 9, 2006
Last updated in NPPESOctober 11, 2011
Mailing address1515 S Clifton Ave, Suite 120, Wichita, KS 67218-2900

Other providers in Wichita