IndividualActive
Jack Okerstrom, DDS, PA
NPI 1295846947 · Orthodontics and Dentofacial Orthopedics Dentistry · Prairie Village, KS
Provider details
- NPI number
- 1295846947
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS, PA
- Sex
- Male
- Sole proprietor
- Yes
- License
- KS52000 (KS)
Specialties & taxonomies
Dental Providers
Practice location
4026 W. 83rd St
Prairie Village, KS 66208
Phone: (913) 469-9191
Fax: (913) 451-2251
Approximate (ZIP-level) locationGet directions
Mailing address
11940 Quivira Rd
Overland Park, KS 66213
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2013-12-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.