Provider Demographics
NPI:1700853710
Name:EDDINS, GAIL J (RDH)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:J
Last Name:EDDINS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:J
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:3510 MESSANIE
Mailing Address - Street 2:
Mailing Address - City:ST JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2129
Mailing Address - Country:US
Mailing Address - Phone:816-364-6444
Mailing Address - Fax:816-364-6929
Practice Address - Street 1:3510 MESSANIE
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2129
Practice Address - Country:US
Practice Address - Phone:816-364-6444
Practice Address - Fax:816-364-6929
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003011307124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH000Medicare UPIN