Provider Demographics
NPI:1437232030
Name:JENDENT, LLC
Entity Type:Organization
Organization Name:JENDENT, LLC
Other - Org Name:BELL TOWNE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:GUGLIELMO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:602-375-8646
Mailing Address - Street 1:2615 N 132ND DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2211
Mailing Address - Country:US
Mailing Address - Phone:623-266-3093
Mailing Address - Fax:
Practice Address - Street 1:401 E BELL RD
Practice Address - Street 2:SUITE 14
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2300
Practice Address - Country:US
Practice Address - Phone:602-375-8646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty