Provider Demographics
NPI:1063048619
Name:KESSEL, JAYNE ALYDA (DDS)
Entity type:Individual
Prefix:DR
First Name:JAYNE
Middle Name:ALYDA
Last Name:KESSEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3101 MACATAWA DR SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-3163
Mailing Address - Country:US
Mailing Address - Phone:616-538-5920
Mailing Address - Fax:
Practice Address - Street 1:3101 MACATAWA DR SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-3163
Practice Address - Country:US
Practice Address - Phone:616-538-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016012001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics