Provider Demographics
NPI:1558045310
Name:SYKES, JALEN CONNOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JALEN
Middle Name:CONNOR
Last Name:SYKES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 FLETCHER AND EDWARDS DR
Mailing Address - Street 2:
Mailing Address - City:HAYSI
Mailing Address - State:VA
Mailing Address - Zip Code:24256-5236
Mailing Address - Country:US
Mailing Address - Phone:276-393-7861
Mailing Address - Fax:
Practice Address - Street 1:15325 LEE HWY
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-4013
Practice Address - Country:US
Practice Address - Phone:276-393-7861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418496122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist