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NPI Code Detail

MEDICARE: JACQUELINE M. PLEMONS, DDS, MS

MEDICARE: JACQUELINE M. PLEMONS, DDS, MS
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
11223P0300XPeriodontics

General Provider Information

NPI Number : 1417158809
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACQUELINE M. PLEMONS, DDS, MS
Provider Business Mailing Address
First Line : 6031 SHERRY LN
Second Line :
City : DALLAS
State : TX
Zip : 75225-6402
Country : US
Telephone Number : 214-369-8585
Fax Number : 214-696-9477
Provider Business Practice Location Address
First Line : 6031 SHERRY LN
Second Line :
City : DALLAS
State : TX
Zip : 75225-6402
Country : US
Telephone Number : 214-369-8585
Fax Number : 214-696-9477
Authorized Official
Title or Position : OWNER
Name : JACQUELINE PLEMONS
Credential : DDS, MS
Telephone Number : 214-369-8585
Provider Enumeration Date : 05/31/2007
Last Update Date : 03/31/2011

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Directions to “JACQUELINE M. PLEMONS, DDS, MS ” Practice Location

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