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General NPI Number Information
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NPI Number | 1336843986
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Entity Type | Individual
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Provider Name | JESSICA ANN DAIBER DDS
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Gender | Female
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1908 EXETER RD
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City | GERMANTOWN
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State | TN
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Zip | 38138-2971
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Country | US
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Telephone | 901-759-9781
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Fax |
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Provider Business Mailing Address
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Address Line | 4869 ESSEXSHIRE AVE
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City | MEMPHIS
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State | TN
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Zip | 38117-5626
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Country | US
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Telephone | 214-663-0714
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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 | 4825
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License Number State | AR
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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 | 12779
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License Number State | TN
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