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General NPI Number Information
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NPI Number | 1750881397
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Entity Type | Individual
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Provider Name | ABBY JEWELL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 2070 NW LOWENSTEIN DR STE C
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City | LEES SUMMIT
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State | MO
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Zip | 64081-1903
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Country | US
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Telephone | 816-287-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 925 NW BENT TREE DR
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City | LEES SUMMIT
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State | MO
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Zip | 64081-1836
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Country | US
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Telephone | 816-560-8351
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D14084
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | ----
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2023005835
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License Number State | MO
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