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General NPI Number Information
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NPI Number | 1366127185
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Entity Type | Individual
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Provider Name | JENNIFER YASHIRA LOZADA RDH, DDS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 256 ASHMONT ST
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City | BOSTON
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State | MA
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Zip | 02124-3804
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Country | US
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Telephone | 617-282-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 774 BEECHMONT ST
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City | HYDE PARK
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State | MA
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Zip | 02136-1331
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Country | US
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Telephone | 617-898-8680
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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 | DN1859800
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License Number State | MA
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