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General NPI Number Information
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NPI Number | 1922448117
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Entity Type | Individual
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Provider Name | JENNIFER MARIE CLEMENTE DDS
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Gender | Female
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 3141 CENTENNIAL BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4094
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Country | US
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Telephone | 719-327-5660
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Fax |
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Provider Business Mailing Address
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Address Line | 6306 OKINAWA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80902-3225
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Country | US
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Telephone | 262-227-5244
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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 | 7080-15
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License Number State | WI
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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 | DN015596
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License Number State | GA
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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 | DN25620
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7080-15
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License Number State | WI
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