Provider Demographics
NPI:1679972467
Name:DHANIREDDY, BHASWANTH (MD)
Entity Type:Individual
Prefix:DR
First Name:BHASWANTH
Middle Name:
Last Name:DHANIREDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6601 WINCHESTER AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4681
Mailing Address - Country:US
Mailing Address - Phone:816-313-2677
Mailing Address - Fax:816-313-6000
Practice Address - Street 1:9301 W 74TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2217
Practice Address - Country:US
Practice Address - Phone:913-632-9100
Practice Address - Fax:913-632-9159
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-419462085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology