DR. JESSICA ALANNA SCULLY BRUNWORTH (NPI# 1912383217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912383217 |
| Entity Type | Individual |
| Full Name | DR. JESSICA ALANNA SCULLY BRUNWORTH |
| Other Name | JESSICA SCULLY |
| Credential | D.D.S., M.S. |
| Practice Address |
1351 Jefferson St Ste 202 Washington MO 63090-6449 |
| Practice Telephone | 3148840478 |
| Mailing Telephone | 3148840478 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2018-11-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 2015023903 | MO | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
2015023903 | MO | Dental Providers |
| Street Address |
1351 JEFFERSON ST STE 202 |
| City | WASHINGTON |
| State | MO |
| Zip Code | 63090-6449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798792 | Alicia Caroline Baker | Nurse Practitioner | 1070 W 7th St, Washington, MO 63090 | 2020-10-21 |
| 1962975839 | Jennifer Biermann | Pharmacist | 801 E 5th Street, Washington, MO 63090 | 2019-01-03 |
| 1487199733 | Kristen Elaine Cleavelin | Registered Nurse | Mercy Convenient Care, 901 Patients First Drive, Washington, MO 63090 | 2016-12-22 |
| 1699146712 | Washington Community Counseling Center | Community/Behavioral Health | 421 W. 5th Street, Suite 110, Washington, MO 63090 | 2015-10-15 |
| 1598002024 | Americare At Vicotrian Manor of Washington, LLC | Assisted Living Facility | 2701 Rabbit Trail Dr, Washington, MO 63090 | 2013-01-03 |
| 1578824116 | Rhonda Ann Pepmiller | Nurse Practitioner | 851 E 5th St Ste 309, Washington, MO 63090 | 2012-05-30 |
| 1932486032 | Julie Joanne Lynch | Pharmacist | 890 Country Corners, Washington, MO 63090 | 2011-11-03 |
| 1043590839 | Laurie Elizabeth Bryson | Counselor | 102 Elm Street, Suite 204, Washington, MO 63090 | 2011-08-24 |
| 1164737490 | Mohan Mallikarjuna Edupuganti | Internal Medicine | 901 Patients First Dr Ste 2500, Washington, MO 63090 | 2010-08-11 |
| 1154640225 | Nicholas W Frederickson | Internal Medicine | 901 Patients First Drive Suite 3300, Washington, MO 63090 | 2010-05-27 |
| Find all providers in zip 63090 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467004341 | Yelena Obholz Dds II Pllc | Dentist | 5101 Wisconsin Ave Nw Ste 107b, Washington, DC 20016-4136 | 2019-07-11 |
| 1588149470 | Amir Shayesteh | Dentist | 600 W St Nw Ste 400, Washington, DC 20059-1022 | 2018-09-26 |
| 1700309861 | Advanced Periodontics of Washington, Pllc | Dentist | 1145 19th St Nw Ste 510, Washington, DC 20036-3715 | 2017-07-20 |
| 1992085724 | Jean Li | Dentist | 1212 New York Ave Nw Ste 430, Washington, DC 20005-3987 | 2011-08-24 |
| 1720393184 | Jaffer F Arastu | Dentist | 1841 Columbia Rd Nw Apt A, Washington, DC 20009-2200 | 2010-08-10 |
| 1275779274 | Marvin F. Grower | Dentist | Howard Univ College of Dent 600 W St Nw, Washington, DC 20059-0001 | 2008-12-21 |
| 1821293465 | Sina Peter Farzin | Dentist | 4545 42nd Street Nw, Suite 108, Washington, DC 20016 | 2007-06-15 |
| 1417030495 | Monette Marie Shuutleworth | Dentist | 5225 Wisconsin Ave Nw Suite #511, Washington, DC 20015 | 2006-10-23 |
| 1689769788 | Specialty Periodontal Care of Washington Pa LLC | Dentist | 2790 West Chestnut Street, Washington, PA 15301 | 2006-10-04 |
| 1518947605 | Armin Abron | Dentist | 1712 Eye St Nw, Suite 202, Washington, DC 20006-3702 | 2006-01-17 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 63090 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.