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NPI Code Detail

MEDICARE: DR. JENNIFER MAILINH BLANTON D.D.S.

MEDICARE: DR. JENNIFER MAILINH BLANTON D.D.S.
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
1122300000XDentist27198TX

General Provider Information

NPI Number : 1477841377
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER MAILINH BLANTON D.D.S.
Provider Business Mailing Address
First Line : 10806 W BELLFORT ST
Second Line :
City : HOUSTON
State : TX
Zip : 77099-4751
Country : US
Telephone Number : 832-877-3505
Fax Number :
Provider Business Practice Location Address
First Line : 13930 BELLAIRE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77083-1719
Country : US
Telephone Number : 713-773-0803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2011
Last Update Date : 06/26/2023

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