Latasha Vick, DDS in Baxter Springs, KS - Dentist

Latasha Vick, DDS is a Dentist - General Practice based in Baxter Springs, Kansas. Latasha Vick is licensed to practice in Kansas (license number 61068) and her current practice location is 2990 Military Ave, Baxter Springs, Kansas. She can be reached at her office (for appointments etc.) via phone at (620) 856-2900.

NPI number for Latasha Vick is 1669456364 and her current mailing address is 3011 N Michigan St, Pittsburg, Kansas. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669456364.

Contact Information

	Latasha Vick, DDS
	2990 Military Ave, Baxter Springs, KS 66713-2331
	(620) 856-2900
	(620) 856-2901

Provider's Profile

Full Name	Latasha Vick
Gender	Female
Speciality	Dentist - General Practice
Location	2990 Military Ave, Baxter Springs, Kansas
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1669456364
Provider Enumeration Date: 12/06/2005
Last Update Date: 08/20/2013

Medical Identifiers

Medical identifiers for Latasha Vick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669456364	NPI	-	NPPES
1061723	Other	OK	PA LICENSE
200022980B	Medicaid	OK
200022980C	Medicaid	OK

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	1061723 (Oklahoma)	Secondary
363AM0700X	Physician Assistant - Medical	1061723 (Oklahoma)	Secondary
1223G0001X	Dentist - General Practice	61068 (Kansas)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latasha Vick is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Latasha Vick, DDS 3011 N Michigan St, Pittsburg, KS 66762-2546 Ph: (620) 231-9873	Latasha Vick, DDS 2990 Military Ave, Baxter Springs, KS 66713-2331 Ph: (620) 856-2900

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Latasha Vick, DDS - Dentist in Baxter Springs, KS