Healthcare Provider Details

I. General information

NPI: 1437788353
Provider Name (Legal Business Name): SAMANTHA DENISE VALENTINE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

4000 CAMBRIDGE ST MS 4035
KANSAS CITY KS
66160-8501
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-7743
  • Fax: 913-588-9786
Mailing address:
  • Phone: 913-588-7743
  • Fax: 913-588-9786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number05-53532
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: