Provider Demographics
NPI:1407300353
Name:JESKO, JENNIFER AIELLO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:AIELLO
Last Name:JESKO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:GRACE
Other - Last Name:AIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:20389 INTERSTATE 35 STE 200
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2039
Mailing Address - Country:US
Mailing Address - Phone:512-256-8754
Mailing Address - Fax:
Practice Address - Street 1:20389 INTERSTATE 35 STE 200
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2039
Practice Address - Country:US
Practice Address - Phone:512-256-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH30.0252501223G0001X
TX392311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program