Healthcare Provider Details

I. General information

NPI: 1093649212
Provider Name (Legal Business Name): SKIN EQUITY DERMATOLOGY & AESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 VINTAGE CT
EXCELSIOR SPRINGS MO
64024-8011
US

IV. Provider business mailing address

8103 NE 76TH TER
KANSAS CITY MO
64158-1427
US

V. Phone/Fax

Practice location:
  • Phone: 816-352-9393
  • Fax: 816-479-4725
Mailing address:
  • Phone: 816-572-1137
  • Fax: 816-479-4725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. VINESHA BYERS
Title or Position: MANAGING MEMBER
Credential: PA-C
Phone: 816-572-1137