Ravi Jay Rajanna, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2005031231 Issued in MO

Practice address

1399 NE Douglas St
Lees Summit, MO 64086-4607

Phone

(816) 373-0300

Fax

(816) 373-1411

NPI assigned

Feb 5, 2007

Last updated

Jan 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• KC Braces, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lee's Summit, MO
  • NPI 1225785454
  NPD Authorized official
• Summit Sleep Solutions LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lee's Summit, MO
  • NPI 1457157802
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1669511010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864607",
            "telephone_number": "816-373-0300",
            "fax_number": "816-373-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 NE DOUGLAS ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864607",
            "telephone_number": "816-373-0300",
            "fax_number": "816-373-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJANNA",
        "first_name": "RAVI",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2005031231",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IA",
            "license": "09238",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KS",
            "license": "60913",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2005031231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400557203",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Travis Ragon, M.S., M.DIV., L.P.C.
• Brittaney M Rahm, LCSW
• Raintree Chiropractic PC
• Raintree Medical and Chiropractic Center LLC
• Shubha Raja, M.B.B.S.
• Ramadan Rakha
• Lynsey N Ralston, AU.D.
• Andrew F. Ramaley, CRNA
• Tina Louise Rambo-Faulkner, LCSW
• Bre'Asia Ramirez

• Orthodontics and Dentofacial Orthopedics Dentistry in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.