Country Club Dental Pa is a Dental Clinic in Topeka, Kansas. It is located at 400 Sw 29th St, Suite M, Topeka, KS and its contact number is 785-783-5981. The authorized person for Country Club Dental Pa is Shaun Urbanozo
who is Credentialing Manager of the clinic and their contact number is 719-323-2362.
Country Club Dental Pa Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Country Club Dental Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Country Club Dental Pa |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 400 Sw 29th St, Suite M, Topeka,
Kansas, 66611-1164 |
| Phone: | 785-783-5981 |
| Fax: | 785-783-5982 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Shaun Urbanozo |
| Position: | Credentialing Manager |
| Contact Number: | 719-323-2362 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Country Club Dental Pa clinic are as mentioned below.
| NPI Number: | 1699137109 |
| NPI Enumeration Date: | 23 Mar, 2016 |
| NPI Last Update On: | 09 Sep, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Country Club Dental Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | | Kansas | Primary | |
| General Practice | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 201199030A | Medicaid | Kansas | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Country Club Dental Pa
2221 E Bijou St, Ste 100
Colorado Springs, Colorado |
| Zip: | 80909-8009 |
| Phone Number: | 719-576-1850 |
| Fax Number: | 719-955-3470 |
Patients can reach Country Club Dental Pa at
400 Sw 29th St, Suite M, Topeka, Kansas or can
call to book an appointment on 785-783-5981.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.