Provider Demographics
NPI:1730348541
Name:DANDACHE, PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DANDACHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E MEYER BLVD BLDG 2
Mailing Address - Street 2:SUITE 392
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1105
Mailing Address - Country:US
Mailing Address - Phone:816-822-8486
Mailing Address - Fax:816-822-0490
Practice Address - Street 1:20 NE SAINT LUKES BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6001
Practice Address - Country:US
Practice Address - Phone:816-822-8486
Practice Address - Fax:816-822-0490
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011036697207RI0200X, 207RI0200X
KS04-35293207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209578301Medicaid
KS200973370AMedicaid
MO278F00006Medicare Oscar/Certification
MO209578301Medicaid
KS200973370AMedicaid