Provider Demographics
NPI:1346272978
Name:BISHOP, JESSICA LYNN (DDSPA)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNN
Last Name:BISHOP
Suffix:
Gender:F
Credentials:DDSPA
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS,PA
Mailing Address - Street 1:6015 FARRINGTON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8154
Mailing Address - Country:US
Mailing Address - Phone:919-489-2793
Mailing Address - Fax:919-402-1852
Practice Address - Street 1:6015 FARRINGTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8154
Practice Address - Country:US
Practice Address - Phone:919-489-2793
Practice Address - Fax:919-402-1852
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice