Provider Demographics
NPI:1326303777
Name:TRIOLA, JENNI M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNI
Middle Name:M
Last Name:TRIOLA
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 1:102 SMART PL
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2040
Mailing Address - Country:US
Mailing Address - Phone:856-414-0059
Mailing Address - Fax:985-649-0949
Practice Address - Street 1:102 SMART PL
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2040
Practice Address - Country:US
Practice Address - Phone:985-641-4005
Practice Address - Fax:985-649-0949
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8082122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1326303777OtherDENTAL