Healthcare Provider Details

I. General information

NPI: 1295020071
Provider Name (Legal Business Name): JENNIFER L SAPP DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER L PRESTON

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FILLMORE ST FL 5
DENVER CO
80206-4916
US

IV. Provider business mailing address

109 STATE ST STE 5
BOSTON MA
02109-2906
US

V. Phone/Fax

Practice location:
  • Phone: 617-505-1520
  • Fax: 617-928-8401
Mailing address:
  • Phone: 617-505-1520
  • Fax: 617-928-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10035534
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036145784
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP0489
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCDRH.0052632
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: