Healthcare Provider Details

I. General information

NPI: 1801726872
Provider Name (Legal Business Name): MAYCI ROSE WHEELER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAYCI ROSE CUNNINGHAM

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N GAINES DR
CLINTON MO
64735-1132
US

IV. Provider business mailing address

1800 COMMUNITY
CLINTON MO
64735-8804
US

V. Phone/Fax

Practice location:
  • Phone: 844-853-8937
  • Fax:
Mailing address:
  • Phone: 660-885-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2026021803
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: