Healthcare Provider Details

I. General information

NPI: 1285588111
Provider Name (Legal Business Name): MIGUEL SALINAS GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 N 12TH ST STE 400
KANSAS CITY KS
66102-5172
US

IV. Provider business mailing address

10205 E 53RD ST
RAYTOWN MO
64133-2245
US

V. Phone/Fax

Practice location:
  • Phone: 816-922-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2025031218
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number13384
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: