Provider Demographics
NPI:1467645895
Name:DUNN, OLUWAMODUPE MELINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUWAMODUPE
Middle Name:MELINDA
Last Name:DUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUWAMODUPE
Other - Middle Name:MELINDA
Other - Last Name:OLOMIYE DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12608 ALHAMBRA ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2259
Mailing Address - Country:US
Mailing Address - Phone:816-225-2621
Mailing Address - Fax:816-225-2621
Practice Address - Street 1:12541 FOSTER ST STE 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213
Practice Address - Country:US
Practice Address - Phone:913-317-3200
Practice Address - Fax:913-317-3218
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009033145207Q00000X
KS04-34721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG93000029Medicare PIN