Provider Demographics
NPI:1043849250
Name:D & T MANAGEMENT GROUP LLC
Entity type:Organization
Organization Name:D & T MANAGEMENT GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:AAHCA; CMA;FTS
Authorized Official - Phone:316-634-1774
Mailing Address - Street 1:9747 E 21ST ST N STE 125
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3557
Mailing Address - Country:US
Mailing Address - Phone:316-634-1774
Mailing Address - Fax:
Practice Address - Street 1:9747 E 21ST ST N STE 125
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3557
Practice Address - Country:US
Practice Address - Phone:316-634-1774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332900000XSuppliersNon-Pharmacy Dispensing Site
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies