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General NPI Number Information
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NPI Number | 1053922385
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Entity Type | Organization
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Legal Business Name | JENKINS PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 6810 SILVERHEEL ST
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City | SHAWNEE
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State | KS
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Zip | 66226-5300
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Country | US
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Telephone | 913-745-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 9420 MANOR RD
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City | LEAWOOD
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State | KS
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Zip | 66206-1833
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Country | US
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Telephone | 913-486-6324
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JILL C JENKINS
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Credential | DDS
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Telephone | 913-486-6324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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