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General NPI Number Information
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NPI Number | 1699331363
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Entity Type | Organization
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Legal Business Name | CHET JENKINS PC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 18505 ALDERWOOD MALL PKWY
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City | LYNNWOOD
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State | WA
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Zip | 98037-8012
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Country | US
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Telephone | 425-329-6677
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Fax |
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Provider Business Mailing Address
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Address Line | 410 N 44TH ST STE 600
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City | PHOENIX
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State | AZ
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Zip | 85008-7616
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Country | US
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Telephone | 480-626-4154
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MELODY BENNION
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Credential |
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Telephone | 480-234-8490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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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 |
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License Number State |
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