MEDICARE: JARED DON PEARSON DDS

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	1223P0221X	Pediatric Dentistry	2021041645	MO
2	1223P0221X	Pediatric Dentistry	5279193-9922	UT

General Provider Information

NPI Number	:	1235200049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED DON PEARSON DDS

Provider Business Mailing Address
First Line	:	8030 N CALDWELL AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-1608
Country	:	US
Telephone Number	:	801-602-9595
Fax Number	:

Provider Business Practice Location Address
First Line	:	8030 N CALDWELL AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-1608
Country	:	US
Telephone Number	:	801-602-9595
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	02/26/2024

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