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Provider Information for 1285805549



BRIAN H JENKINS DDS

Gender: MALE

Individual NPI: 1285805549

Calendar Last Updated: 2015-12-15

Details

Name Value
NPI 1285805549
Enumeration Date 2008-03-14
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 17049 BEL RAY BLVD
BELTON, MO 64012-5371
United States

Phone: 816-322-6551 | Fax: 816-322-5819
View Map External Link
Primary Practice Address 17049 BEL RAY BLVD
BELTON, MO 64012-5371
United States

Phone: 816-322-6551 | Fax: 816-322-5819
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MO 2014028884