Basic Information
| Provider Information | |||||||||
| NPI: | 1518606235 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARLING | ||||||||
| FirstName: | CASSIDY | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2933 S 47TH ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661063739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136771004 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2933 S 47TH ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661063739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136771004 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2022 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 2022019284 | MO | N | Dental Providers | Dentist | 122300000X | 61873 | KS | Y | Dental Providers | Dentist |
No ID Information.