Provider Demographics
NPI:1558533604
Name:CALNON, JENNIFER J (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:CALNON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 CULVER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-1716
Mailing Address - Country:US
Mailing Address - Phone:585-467-2745
Mailing Address - Fax:585-467-5683
Practice Address - Street 1:2615 CULVER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-1716
Practice Address - Country:US
Practice Address - Phone:585-467-2745
Practice Address - Fax:585-467-5683
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0544541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice