Provider Demographics
NPI:1275986846
Name:PARRISH, JALISA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:JALISA
Middle Name:B
Last Name:PARRISH
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 1:512 COKE AVE
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1539
Mailing Address - Country:US
Mailing Address - Phone:252-482-1080
Mailing Address - Fax:
Practice Address - Street 1:512 COKE AVE
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1539
Practice Address - Country:US
Practice Address - Phone:252-482-1080
Practice Address - Fax:252-482-1082
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC107681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice