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General NPI Number Information
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NPI Number | 1316687791
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Entity Type | Individual
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Provider Name | JENIFFER JENN PAEZ DMD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 2137 HWY 35 STE 240
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City | HOLMDEL
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State | NJ
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Zip | 07733-1083
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Country | US
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Telephone | 732-410-5388
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Fax |
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Provider Business Mailing Address
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Address Line | 2137 HWY 35 STE 240
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City | HOLMDEL
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State | NJ
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Zip | 07733-1083
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Country | US
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Telephone | 732-410-5388
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI03037400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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