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General NPI Number Information
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NPI Number | 1417271115
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Entity Type | Organization
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Legal Business Name | JENNIFER M. JENKINS, DDS, PC
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 6800 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-1809
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Country | US
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Telephone | 405-631-7571
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Fax | 405-631-3305
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Provider Business Mailing Address
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Address Line | 6800 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-1809
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Country | US
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Telephone | 405-631-7571
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Fax | 405-631-3305
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Authorized Official
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Title or Position | PRESIDENT/ DENTIST
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Name | DR. JENNIFER M. JENKINS
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Credential | D.D.S.
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Telephone | 405-631-7571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 6030
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License Number State | OK
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