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NPI Code Detail

MEDICARE: HUGH JERNIGAN, DMD PLLC

MEDICARE: HUGH JERNIGAN, DMD PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1316681380
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUGH JERNIGAN, DMD PLLC
Provider Business Mailing Address
First Line : 2418 E DESERT COVE AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-2522
Country : US
Telephone Number : 602-315-9722
Fax Number :
Provider Business Practice Location Address
First Line : 7102 E ACOMA DR STE 3
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85254-2771
Country : US
Telephone Number : 480-556-0310
Fax Number :
Authorized Official
Title or Position : DOCTOR/OWNER
Name : DR. HUGH WARREN JERNIGAN
Credential : DMD
Telephone Number : 602-315-9722
Provider Enumeration Date : 04/25/2022
Last Update Date : 04/25/2022

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Directions to “HUGH JERNIGAN, DMD PLLC ” Practice Location

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