Provider Demographics
NPI:1699866715
Name:DULIN, JOSE I (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:I
Last Name:DULIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY STE 312
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:5701 STATE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1286
Practice Address - Country:US
Practice Address - Phone:913-945-9640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011004798207RC0000X
KS04-19329207RC0000X
KS0419329207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100173490JMedicaid
MO1699866715Medicaid
MO09449168OtherBCBS KC
KS100173490HMedicaid
KS038B00008Medicare PIN
KS100173490JMedicaid
MO09449168OtherBCBS KC
MO038A00013Medicare PIN
KS038B00001Medicare PIN
KS110330004Medicare PIN
KS055781Medicare ID - Type Unspecified