Provider Demographics
NPI:1043711021
Name:ARMSTRONG, JENNY RUTH (DDS)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:RUTH
Last Name:ARMSTRONG
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 1:511 47TH AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5790
Mailing Address - Country:US
Mailing Address - Phone:203-247-0415
Mailing Address - Fax:
Practice Address - Street 1:241 W 37TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5705
Practice Address - Country:US
Practice Address - Phone:203-247-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0605981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice