NPI 1336775402 · live from the CMS NPI Registry
Jordan Andrew Dykstra, MD
Dermatology in Overland Park, KS. National Provider Identifier 1336775402, active.
NPI record
| NPI | 1336775402 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 10740 Nall Ave, Overland Park, KS 66211 |
| Practice phone | 913-588-1227 |
| Mailing address | 11201 Outlook St Apt 1217, Overland Park, KS 66211 |
| Enumerated | March 20, 2020 |
| Last updated | August 6, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | 04-51181 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.