Provider Demographics
NPI:1235299900
Name:BERRY, DANIEL KENNETH (DO, MS,PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:KENNETH
Last Name:BERRY
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Gender:M
Credentials:DO, MS,PHD
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Mailing Address - Street 1:10821 S WHITETAIL LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-9395
Mailing Address - Country:US
Mailing Address - Phone:913-254-8532
Mailing Address - Fax:913-254-8539
Practice Address - Street 1:901 LOCUST STREET, ROOM 350
Practice Address - Street 2:ACE300
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-9721
Practice Address - Country:US
Practice Address - Phone:816-329-3250
Practice Address - Fax:816-329-3266
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2022-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2448207Q00000X, 2083A0100X
NJ25MB05854600207Q00000X, 2083A0100X
KS05-356292083A0100X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine