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1669049243 NPI number — JENNIFER KELSEY BELTZ DMD

NPI Number: 1669049243
Health Care Provider/Practitioner: JENNIFER KELSEY BELTZ DMD

Information about “1669049243” NPI (JENNIFER KELSEY BELTZ DMD) exists in 1669049243 in HTML format HTML  |  1669049243 in plain Text format TXT  |  1669049243 in PDF (Portable Document Format) PDF  |  1669049243 in an XML format XML  formats.

NPI Number : 1669049243 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669049243",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BELTZ",
    "FirstName": "JENNIFER",
    "MiddleName": "KELSEY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SUMNER",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": "KELSEY",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DMD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4009 TAMPA RD STE 6",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OLDSMAR",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34677-3232",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "813-448-7828",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4009 TAMPA RD STE 6",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OLDSMAR",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34677-3232",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "813-448-7828",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/10/2021",
    "LastUpdateDate": "12/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "DN25964",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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