Individual
DR. RAVI JAY RAJANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1399 NE DOUGLAS ST, LEES SUMMIT, MO 64086-4607
(816) 373-0300
(816) 373-1411
Mailing address
1399 NE DOUGLAS ST, LEES SUMMIT, MO 64086-4607
(816) 373-0300
(816) 373-1411
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2005031231
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
09238
IA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2005031231
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
60913
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400557203
—
MO
Enumeration date
02/05/2007
Last updated
01/25/2023
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