Healthcare Provider Details

I. General information

NPI: 1518994631
Provider Name (Legal Business Name): DAVID S. DYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 QUIVIRA RD STE 100
LENEXA KS
66215-2857
US

IV. Provider business mailing address

8600 QUIVIRA RD STE 100
LENEXA KS
66215-2857
US

V. Phone/Fax

Practice location:
  • Phone: 913-831-7400
  • Fax: 913-831-7409
Mailing address:
  • Phone: 913-831-7400
  • Fax: 913-831-7409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number111975
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number9713727-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number0426713
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number111975
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number9713727-1205
License Number StateUT
# 6
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number04-26713
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: