Provider Demographics
NPI:1689892580
Name:JOURNEE, MICHAEL CONRAD (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CONRAD
Last Name:JOURNEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 NE 81ST ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-8400
Mailing Address - Country:US
Mailing Address - Phone:816-420-9070
Mailing Address - Fax:
Practice Address - Street 1:4910 NE 81ST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-8400
Practice Address - Country:US
Practice Address - Phone:816-420-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS608421223G0001X
MO0159011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice