Provider Demographics
NPI:1871574277
Name:MCAROY, JENNIFER L (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:MCAROY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 TOMAHAWK RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-2618
Mailing Address - Country:US
Mailing Address - Phone:913-789-7455
Mailing Address - Fax:
Practice Address - Street 1:6925 TOMAHAWK RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-2618
Practice Address - Country:US
Practice Address - Phone:913-789-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-11
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS602591223G0001X
MO20040132491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice