Provider Demographics
NPI:1174349930
Name:RAZO, DAKOTA MICHAEL
Entity type:Individual
Prefix:
First Name:DAKOTA
Middle Name:MICHAEL
Last Name:RAZO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 N MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-5832
Mailing Address - Country:US
Mailing Address - Phone:816-820-5922
Mailing Address - Fax:
Practice Address - Street 1:12600 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2402
Practice Address - Country:US
Practice Address - Phone:913-897-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program