Provider Demographics
NPI:1003901968
Name:REKOS, JENNIFER E (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:REKOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 HIGH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3962
Mailing Address - Country:US
Mailing Address - Phone:614-885-5158
Mailing Address - Fax:614-985-1740
Practice Address - Street 1:510 HIGH ST
Practice Address - Street 2:SUITE A
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3962
Practice Address - Country:US
Practice Address - Phone:614-885-5158
Practice Address - Fax:614-985-1740
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300222941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry