Summit Pediatric Dentistry is a Pediatric Dental Clinic in Lees Summit, Missouri. It is located at 24 Nw Chipman Rd Ste B, Lees Summit, MO and its contact number is 816-256-0073. The authorized person for Summit Pediatric Dentistry is Moncy Mathew
who is Owner/dentist of the clinic and their contact number is 816-256-0073. The primary license number for Summit Pediatric Dentistry is 2006037222 (Pediatric Dentistry) in Missouri.
Summit Pediatric Dentistry Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Summit Pediatric Dentistry Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Summit Pediatric Dentistry |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 24 Nw Chipman Rd Ste B, Lees Summit,
Missouri, 64063-1929 |
| Phone: | 816-256-0073 |
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: | Moncy Mathew |
| Position: | Owner/dentist |
| Contact Number: | 816-256-0073 |
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 Summit Pediatric Dentistry clinic are as mentioned below.
| NPI Number: | 1053848374 |
| NPI Enumeration Date: | 17 May, 2017 |
| NPI Last Update On: | 21 Jul, 2022 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Summit Pediatric Dentistry are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 2006037222 | Missouri | 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 |
| 1841474293 | Medicaid | Missouri | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Summit Pediatric Dentistry
24 Nw Chipman Rd Ste B,
Lees Summit, Missouri |
| Zip: | 64063-1929 |
| Phone Number: | 816-256-0073 |
Patients can reach Summit Pediatric Dentistry at
24 Nw Chipman Rd Ste B, Lees Summit, Missouri or can
call to book an appointment on 816-256-0073.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.