Provider Demographics
NPI:1033860838
Name:MCGINNESS, JAYLEE EVONNE (RDH)
Entity Type:Individual
Prefix:
First Name:JAYLEE
Middle Name:EVONNE
Last Name:MCGINNESS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349B THRASHER RD
Mailing Address - Street 2:
Mailing Address - City:WHITE CLOUD
Mailing Address - State:KS
Mailing Address - Zip Code:66094-4005
Mailing Address - Country:US
Mailing Address - Phone:785-595-3450
Mailing Address - Fax:
Practice Address - Street 1:24112 315TH ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-7473
Practice Address - Country:US
Practice Address - Phone:660-254-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021034208124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist