Provider Demographics
NPI:1225141641
Name:DANTO, JAY BRIAN (DO)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:BRIAN
Last Name:DANTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 NE BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2722
Mailing Address - Country:US
Mailing Address - Phone:816-892-0599
Mailing Address - Fax:816-892-0599
Practice Address - Street 1:234 NE BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2722
Practice Address - Country:US
Practice Address - Phone:816-892-0599
Practice Address - Fax:816-866-9003
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT131811204D00000X
UT11624821-8904204D00000X
MICERTIFICATE 8677207Q00000X
MO2012034290204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G75950Medicare UPIN