Provider Demographics
NPI:1508750407
Name:KONNEMAN, LAYNE O'BRYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:LAYNE
Middle Name:O'BRYAN
Last Name:KONNEMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8291 N BOOTH AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-7202
Mailing Address - Country:US
Mailing Address - Phone:816-728-2979
Mailing Address - Fax:
Practice Address - Street 1:8291 N BOOTH AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-7202
Practice Address - Country:US
Practice Address - Phone:816-728-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025019813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist