Healthcare Provider Details

I. General information

NPI: 1881614600
Provider Name (Legal Business Name): JENNIFER N FORSHEY DMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 BALTIMORE BLVD UNIT C-1
WESTMINSTER MD
21157-7098
US

IV. Provider business mailing address

1130 BALTIMORE BLVD UNIT C-1
WESTMINSTER MD
21157-7098
US

V. Phone/Fax

Practice location:
  • Phone: 410-982-0650
  • Fax: 410-982-0655
Mailing address:
  • Phone: 410-982-0650
  • Fax: 410-982-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number13760
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: