Provider Demographics
NPI:1619026275
Name:DUNIVENT, SEAN MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MATTHEW
Last Name:DUNIVENT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 NE HIGHWAY 152
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-7608
Mailing Address - Country:US
Mailing Address - Phone:816-781-2090
Mailing Address - Fax:816-781-2092
Practice Address - Street 1:9205 NE HIGHWAY 152
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-7608
Practice Address - Country:US
Practice Address - Phone:816-781-2090
Practice Address - Fax:816-781-2092
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005026319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO5762118OtherCOVNTRY
MO7398818OtherAETNA
MO7245620OtherAETNA PPO
MO36352029OtherBCBS
MO7398818OtherAETNA