Healthcare Provider Details

I. General information

NPI: 1689295388
Provider Name (Legal Business Name): SHAWN ROBERT DALANGIN RT(R)(VI)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST FL 2
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

3535 BROADWAY BLVD APT 202
KANSAS CITY MO
64111-2730
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6875
  • Fax:
Mailing address:
  • Phone: 816-888-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471V0106X
TaxonomyVascular-Interventional Technology Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: