Healthcare Provider Details

I. General information

NPI: 1841124674
Provider Name (Legal Business Name): VANESSA BENHUMEA RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 S MAIDEN LN
JOPLIN MO
64801-3084
US

IV. Provider business mailing address

513 S GRANDVIEW ST
ANDERSON MO
64831-9750
US

V. Phone/Fax

Practice location:
  • Phone: 417-782-0080
  • Fax: 417-782-0096
Mailing address:
  • Phone: 479-326-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2026025463
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: