Provider Demographics
NPI:1073044087
Name:SYLVIAN, JENNIFER J (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:SYLVIAN
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 1:3513 NW 33RD CT
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5407
Mailing Address - Country:US
Mailing Address - Phone:954-663-9995
Mailing Address - Fax:
Practice Address - Street 1:135 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SOUTH BAY
Practice Address - State:FL
Practice Address - Zip Code:33493-2213
Practice Address - Country:US
Practice Address - Phone:954-663-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN238821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry