Provider Demographics
NPI:1164642260
Name:EHRHART, JEANNE (DDS)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:EHRHART
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:KINGS BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:96143
Mailing Address - Country:US
Mailing Address - Phone:530-546-3297
Mailing Address - Fax:530-546-4806
Practice Address - Street 1:8233 RAINBOW AVE
Practice Address - Street 2:
Practice Address - City:KINGS BEACH
Practice Address - State:CA
Practice Address - Zip Code:96143
Practice Address - Country:US
Practice Address - Phone:530-546-3297
Practice Address - Fax:530-546-4806
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADJ29042122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist