Healthcare Provider Details

I. General information

NPI: 1881036267
Provider Name (Legal Business Name): JENNIFER RENEE SCHLESINGER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER RENEE TAYLOR DMD

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 12/21/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15706 POMERADO RD
POWAY CA
92064-2067
US

IV. Provider business mailing address

2948 UNIVERSITY AVE
SAN DIEGO CA
92104-2934
US

V. Phone/Fax

Practice location:
  • Phone: 302-270-4641
  • Fax:
Mailing address:
  • Phone: 619-684-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS039526
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS039526
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDDS103684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: