Provider Demographics
NPI:1730756404
Name:DENNIS, MICHAEL DAVID (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:DENNIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3901 RAINBOW BLVD, 5026 WESCOE
Mailing Address - Street 2:MS 2026
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6009
Mailing Address - Fax:913-588-3987
Practice Address - Street 1:3901 RAINBOW BLVD, 5026 WESCOE
Practice Address - Street 2:MS 2026
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6009
Practice Address - Fax:913-588-3987
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2024-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAR-12139207R00000X
KS94-11926207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine