Healthcare Provider Details

I. General information

NPI: 1770394769
Provider Name (Legal Business Name): SANAM MARIE BEZANSON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 METCALF AVE STE 201
OVERLAND PARK KS
66213-2831
US

IV. Provider business mailing address

12701 METCALF AVE STE 201
OVERLAND PARK KS
66213-2831
US

V. Phone/Fax

Practice location:
  • Phone: 918-406-4154
  • Fax:
Mailing address:
  • Phone: 918-406-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-06379
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: