Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Adult and Pediatric Dermatology

Organization Dermatology Physician · NPI 1609966753

Adult and Pediatric Dermatology provides Dermatology Physician services in Overland Park, Kansas. Licensed in Kansas. Registered with an NPI since 2006.

Licensed in
KS
In the registry since
2006

Practice location Address checks out

4601 W 109th St Ste 116
Overland Park, KS 66211-1313
Phone: (913) 469-1115
Fax: (913) 469-9192
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 0422209 (KS)

Record details

NPI number1609966753
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jenean Kemp — Administrator · (913) 948-9184
NPI enumeratedOctober 12, 2006
Last updated in NPPESJuly 13, 2022
Certification dateJuly 13, 2022
Mailing address4601 W. 109th Street, Suite 116, Overland Park, KS 66211-1313

Other providers in Overland Park