MEDICARE: DR. JEANNE PINZEL STRATHEARN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6909	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023090313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANNE PINZEL STRATHEARN DDS

Provider Business Mailing Address
First Line	:	12 N MAIN ST STE 101
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-1932
Country	:	US
Telephone Number	:	860-236-4249
Fax Number	:	860-231-1571

Provider Business Practice Location Address
First Line	:	12 N MAIN ST
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-1932
Country	:	US
Telephone Number	:	860-236-4249
Fax Number	:	860-231-1571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	11/19/2013

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