=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093612574
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER LOYA-LEDEZMA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2026
-----------------------------------------------------
Last Update Date | 10/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 926 FRANKLIN BLVD
-----------------------------------------------------
City | LEMOORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93246-4500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-998-4210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 319 W SAN JOAQUIN AVE
-----------------------------------------------------
City | TULARE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93274-3827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-303-7459
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | 37878
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------