Organization · Type 2 NPI

Country Club Dental PA

General Practice Dentistry · Topeka, KS

NPI number 1699137109 Active

Practice location

400 SW 29th St, Suite M
Topeka, KS 66611-1164

Call (785) 783-5981 Map

Fax (785) 783-5982

Mailing address

2221 E Bijou St, Ste 100
Colorado Springs, CO 80909-8009

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry	1223G0001X	None listed
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Other general practice dentistry providers in Topeka

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NPI record

NPI: 1699137109
Entity type: Organization (Type 2)
Issued: Mar 23, 2016
Last updated: Sep 9, 2025
Status: Active

Other names

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Adventure Dental and Vision · doing business as
Adventure Dental and Vision · doing business as

Authorized official

Shaun Urbanozo
Credentialing Manager
(719) 323-2362

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1699137109

Country Club Dental PA's National Provider Identifier is 1699137109, issued on Mar 23, 2016. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Topeka, KS. The record was last updated on Sep 9, 2025.