Provider Demographics
NPI:1023244894
Name:SCHUPP, BARBARA OPSAHL (DDS)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:OPSAHL
Last Name:SCHUPP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1393
Mailing Address - Country:US
Mailing Address - Phone:785-842-9223
Mailing Address - Fax:785-842-4335
Practice Address - Street 1:346 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1393
Practice Address - Country:US
Practice Address - Phone:785-842-9223
Practice Address - Fax:785-842-4335
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS609411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry