Provider Demographics
NPI:1134281660
Name:DOOLEN, JASON (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:DOOLEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13611 SKINNER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1018
Mailing Address - Country:US
Mailing Address - Phone:281-758-1600
Mailing Address - Fax:281-256-1903
Practice Address - Street 1:13611 SKINNER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1018
Practice Address - Country:US
Practice Address - Phone:281-758-1600
Practice Address - Fax:281-256-1903
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics