Healthcare Provider Details

I. General information

NPI: 1407532963
Provider Name (Legal Business Name): NATHANIEL CURTISS DISMANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NATHAN DISMANG MD

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

3901 RAINBOW BLVD MS 1045
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 816-438-1360
  • Fax:
Mailing address:
  • Phone: 816-438-1360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04-53396
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2025022559
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: