MEDICARE: DR. JARROD CRAIG CORNEHL 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
1	1223G0001X	General Practice Dentistry	52365	CA
2	1223G0001X	General Practice Dentistry	20982	TX
3	1223G0001X	General Practice Dentistry	DN28948	FL

General Provider Information

NPI Number	:	1619975117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARROD CRAIG CORNEHL D.D.S.

Provider Business Mailing Address
First Line	:	1711 GREGORY RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6738
Country	:	US
Telephone Number	:	415-746-0746
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 S ALTERNATE A1A STE 600
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33477-4064
Country	:	US
Telephone Number	:	415-746-0746
Fax Number	:

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	01/19/2026

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