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General NPI Number Information
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NPI Number | 1336106996
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Entity Type | Individual
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Provider Name | JARED O DEAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 61121 SOUTHGATE RD
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City | CAMBRIDGE
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State | OH
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Zip | 43725
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Country | US
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Telephone | 740-439-5335
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Fax | 740-439-2382
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Provider Business Mailing Address
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Address Line | 61121 SOUTHGATE RD
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City | CAMBRIDGE
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State | OH
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Zip | 43725
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Country | US
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Telephone | 740-439-5335
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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 | 08215
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License Number State | IA
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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 | 8449
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.022996
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License Number State | OH
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