John R Provenzano Dds,pa
Oral and Maxillofacial Dental Clinic
1515 S Clifton Ave Ste 120, Wichita
Kansas, 67218-2951
316-681-3757 316-652-0602
Maps & DirectionsJohn R Provenzano Dds,pa is a Oral and Maxillofacial Dental Clinic in Wichita, Kansas. It is located at 1515 S Clifton Ave Ste 120, Wichita, KS and its contact number is 316-681-3757. The authorized person for John R Provenzano Dds,pa is John R Provenzano
who is Owner of the clinic and their contact number is 316-681-3757. The primary license number for John R Provenzano Dds,pa is 6557 (Oral and Maxillofacial Surgery) in Kansas.
John R Provenzano Dds,pa Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
John R Provenzano Dds,pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | John R Provenzano Dds,pa |
| Specialization: | Oral and Maxillofacial Surgery |
| Clinic Address: | 1515 S Clifton Ave Ste 120, Wichita,
Kansas, 67218-2951 |
| Phone: | 316-681-3757 |
| Fax: | 316-652-0602 |
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: | John R Provenzano |
| Position: | Owner |
| Contact Number: | 316-681-3757 |
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 John R Provenzano Dds,pa clinic are as mentioned below.
| NPI Number: | 1639449259 |
| NPI Enumeration Date: | 12 Jan, 2012 |
| NPI Last Update On: | 09 Feb, 2012 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for John R Provenzano Dds,pa are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral and Maxillofacial Surgery | 6557 | Kansas | Primary | |
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 |
| 019243 | Other | Kansas | Medicare P-tan |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | John R Provenzano Dds,pa
1515 S Clifton Ave Ste 120,
Wichita, Kansas |
| Zip: | 67218-2951 |
| Phone Number: | 316-681-3757 |
| Fax Number: | 316-652-0602 |
Patients can reach John R Provenzano Dds,pa at
1515 S Clifton Ave Ste 120, Wichita, Kansas or can
call to book an appointment on 316-681-3757.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
09 February, 2026.