Provider Demographics
NPI:1023198231
Name:HUGHES, JENNIFER INGELS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:INGELS
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N 40TH AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-6663
Mailing Address - Country:US
Mailing Address - Phone:601-261-5541
Mailing Address - Fax:601-261-5542
Practice Address - Street 1:114 N 40TH AVE
Practice Address - Street 2:SUITE G
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6663
Practice Address - Country:US
Practice Address - Phone:601-261-5541
Practice Address - Fax:601-261-5542
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3093-991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice