Healthcare Provider Details

I. General information

NPI: 1225141641
Provider Name (Legal Business Name): JAY BRIAN DANTO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 NE BARRY RD
KANSAS CITY MO
64155-2722
US

IV. Provider business mailing address

234 NE BARRY RD
KANSAS CITY MO
64155-2722
US

V. Phone/Fax

Practice location:
  • Phone: 816-892-0599
  • Fax: 816-866-9003
Mailing address:
  • Phone: 816-892-0599
  • Fax: 816-892-0599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number131811
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number11624821-8904
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCERTIFICATE 8677
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number2012034290
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: