Healthcare Provider Details

I. General information

NPI: 1114668613
Provider Name (Legal Business Name): JESSICA AMANDA ZHOLENDZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 US HIGHWAY 9 STE 100
MANALAPAN NJ
07726-9217
US

IV. Provider business mailing address

111 WHITLOCK CT
MANALAPAN NJ
07726-7938
US

V. Phone/Fax

Practice location:
  • Phone: 732-577-1515
  • Fax:
Mailing address:
  • Phone: 732-577-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02982400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: