Provider Demographics
NPI:1285433656
Name:DEW AESTHETICS & WELLNESS, LLC.
Entity type:Organization
Organization Name:DEW AESTHETICS & WELLNESS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BURDOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:913-368-9246
Mailing Address - Street 1:5900 NIEMAN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2906
Mailing Address - Country:US
Mailing Address - Phone:913-368-9246
Mailing Address - Fax:
Practice Address - Street 1:5900 NIEMAN RD STE 300
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2906
Practice Address - Country:US
Practice Address - Phone:913-368-9246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty