Healthcare Provider Details

I. General information

NPI: 1447129820
Provider Name (Legal Business Name): KENDRA DUMSKY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 SHAWNEE MISSION PKWY
FAIRWAY KS
66205-2528
US

IV. Provider business mailing address

4618 W 63RD ST
PRAIRIE VILLAGE KS
66208-1511
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-0555
  • Fax:
Mailing address:
  • Phone: 816-812-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number2025034980
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: