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General NPI Number Information
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NPI Number | 1134357676
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Entity Type | Individual
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Provider Name | JENNIFER ANNE FIELDS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 1348 8TH ST NE
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City | AUBURN
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State | WA
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Zip | 98002-4556
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Country | US
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Telephone | 253-939-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 N MOUNTAIN VIEW AVE #E24
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City | TACOMA
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State | WA
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Zip | 98406-1099
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Country | US
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Telephone | 952-486-1218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE 60355119
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D12652
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License Number State | MN
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