MEDICARE: JACQUELYN SLOOP D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2013018444	MO
2	1223G0001X	General Practice Dentistry	60984	KS

General Provider Information

NPI Number	:	1013355825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELYN SLOOP D.D.S.

Provider Business Mailing Address
First Line	:	6306 MORNINGSIDE DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2309
Country	:	US
Telephone Number	:	816-523-6615
Fax Number	:

Provider Business Practice Location Address
First Line	:	6306 MORNINGSIDE DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2309
Country	:	US
Telephone Number	:	816-523-6615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	04/06/2026

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