Provider Demographics
NPI:1942949490
Name:BEISNER, JESSICA (RDH)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BEISNER
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 1:214 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-3451
Mailing Address - Country:US
Mailing Address - Phone:308-293-8326
Mailing Address - Fax:
Practice Address - Street 1:516 W 11TH ST STE 108B
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-7310
Practice Address - Country:US
Practice Address - Phone:888-669-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2592124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist