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General NPI Number Information
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NPI Number | 1780138222
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Entity Type | Individual
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Provider Name | ERIN E. PENDER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2016
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 107 INSTITUTE ST
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City | JAMESTOWN
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State | NY
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Zip | 14701-6628
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Country | US
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Telephone | 716-484-4334
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Fax | 716-484-4335
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Provider Business Mailing Address
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Address Line | 3793 ROUTE 394
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City | ASHVILLE
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State | NY
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Zip | 14710-9749
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Country | US
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Telephone |
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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 | 30.24864
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901022056
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 06012
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 06012
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License Number State | NY
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