Healthcare Provider Details

I. General information

NPI: 1124955778
Provider Name (Legal Business Name): ABB DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 1/2 N MO-7 HWY
PLEASANT HILL MO
64080
US

IV. Provider business mailing address

1448 WOODLAND RD
GREENWOOD MO
64034-8983
US

V. Phone/Fax

Practice location:
  • Phone: 785-443-2520
  • Fax:
Mailing address:
  • Phone: 785-443-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KAYLA D HANNA
Title or Position: OWNER
Credential: DDS
Phone: 785-443-2520