Jessica Bennett
Individual provider Active NPI Dental Hygienist · Seymour, MO
NPI 1043085186 · NPPES record last updated Nov 20, 2023
Key facts
- NPI
- 1043085186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 2023021212 (MO)
- Practice address
- 205 N Commercial St
Seymour, MO 65746-8859 - Phone
- (417) 935-2141
- NPI assigned
- Nov 20, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023021212 | MO | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2023021212 | MO | Yes |
Addresses
Primary practice location
205 N Commercial St
Seymour, MO 65746-8859
Mailing address
205 N Commercial St
Seymour, MO 65746-8859
Other practice location 1
2381 Highway Ee
Mansfield, MO 65704-8447
Phone (417) 241-5354
Other providers in Seymour, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.