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General NPI Number Information
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NPI Number | 1205628708
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Entity Type | Individual
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Provider Name | JESSICA MARIE LIGNELLI RDH
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 516 STRAND ST
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City | FREDERIKSTED
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State | VI
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Zip | 00840-3533
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Country | US
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Telephone | 340-772-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 105 TURPIAL WAY APT 107
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City | MELBOURNE
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State | FL
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Zip | 32901-8917
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Country | US
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Telephone | 407-848-6778
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH18940
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License Number State | FL
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