Provider Demographics
NPI:1447045794
Name:HILL, AVERY MICHAEL (DDS)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:MICHAEL
Last Name:HILL
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 RIVERS EDGE PKWY APT 443
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-5204
Mailing Address - Country:US
Mailing Address - Phone:313-475-0146
Mailing Address - Fax:
Practice Address - Street 1:8615 ROSEHILL RD STE 101
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2897
Practice Address - Country:US
Practice Address - Phone:913-251-9683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program