Provider Demographics
NPI:1194012385
Name:REMAKEL, JEFFREY ROSS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ROSS
Last Name:REMAKEL
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 1:5000 W 36TH ST STE 250
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2776
Mailing Address - Country:US
Mailing Address - Phone:952-920-3700
Mailing Address - Fax:
Practice Address - Street 1:5000 W 36TH ST STE 250
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2776
Practice Address - Country:US
Practice Address - Phone:952-920-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist