Provider Demographics
NPI:1114363520
Name:HEMSATH, JESSE LEE (DDS)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:LEE
Last Name:HEMSATH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-3222
Mailing Address - Country:US
Mailing Address - Phone:319-231-1786
Mailing Address - Fax:
Practice Address - Street 1:322 DENTAL SCIENCE S
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1001
Practice Address - Country:US
Practice Address - Phone:319-335-7440
Practice Address - Fax:319-335-7451
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program