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Country Club Dental PA

General Practice Dentistry in Topeka, KS · enumerated 2016 · authorized official Shaun Urbanozo, Credentialing Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1699137109

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Registry record

Entity type Organization (Type 2)
Legal business name Country Club Dental PA
Other name <Unavail>
Practice address 400 Sw 29th St, Suite M, Topeka, KS, 66611
Phone (785) 783-5981
Fax (785) 783-5982
Enumeration date Mar 23, 2016
Last updated in NPPES Sep 9, 2025

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers Secondary
1223G0001X General Practice Dentistry Dental Providers Primary

Authorized official

Name Shaun Urbanozo
Title Credentialing Manager
Phone (719) 323-2362

Other identifiers

Identifier Type State Issuer
201199030A Medicaid KS -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Country Club Dental PA?
Country Club Dental PA is registered in NPPES as a General Practice Dentistry (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-09.