Provider Demographics
NPI:1518125665
Name:ROCHA, JENNIFER JONES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JONES
Last Name:ROCHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LEAH
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:13510 N ROME AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2027
Mailing Address - Country:US
Mailing Address - Phone:813-269-9466
Mailing Address - Fax:
Practice Address - Street 1:13510 N ROME AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2027
Practice Address - Country:US
Practice Address - Phone:813-269-9466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN182751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice