Provider Demographics
NPI:1487860649
Name:LAMPHIER, JENNIFER LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:LAMPHIER
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 1:171 WOODPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2633
Mailing Address - Country:US
Mailing Address - Phone:973-729-7979
Mailing Address - Fax:973-729-0946
Practice Address - Street 1:171 WOODPORT RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2633
Practice Address - Country:US
Practice Address - Phone:973-729-7979
Practice Address - Fax:973-729-0946
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020741001223S0112X
NJ22DI020741021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPROFESSION : DENTISMedicare UPIN
NJU94462Medicare UPIN