MEDICARE: DR. JENNIFER ELIZABETH NEHODA CHRISTY DDS

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
1	122300000X	Dentist	30.023697	OH

General Provider Information

NPI Number	:	1356604011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER ELIZABETH NEHODA CHRISTY DDS

Provider Business Mailing Address
First Line	:	PO BOX 3189
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13220-3189
Country	:	US
Telephone Number	:	866-273-8204
Fax Number	:	866-803-4943

Provider Business Practice Location Address
First Line	:	1100 SUNBURY RD
Second Line	:	UNIT 712
City	:	DELAWARE
State	:	OH
Zip	:	43015-6040
Country	:	US
Telephone Number	:	740-362-5800
Fax Number	:	740-362-0620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2012
Last Update Date	:	07/18/2016

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