Provider Demographics
NPI:1275812810
Name:GORELIK, JESSICA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:GORELIK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2431
Mailing Address - Country:US
Mailing Address - Phone:201-944-1969
Mailing Address - Fax:
Practice Address - Street 1:6 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2431
Practice Address - Country:US
Practice Address - Phone:201-944-1969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-14
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0555751223G0001X
NJ22D1025648001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice