Provider Demographics
NPI:1598078529
Name:MOXEY, JAYDE ISMAE NADIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAYDE
Middle Name:ISMAE NADIA
Last Name:MOXEY
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 1:21 TEMPLE ST APT 305
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-1311
Mailing Address - Country:US
Mailing Address - Phone:804-787-3181
Mailing Address - Fax:
Practice Address - Street 1:1131 TOLLAND TPKE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-1679
Practice Address - Country:US
Practice Address - Phone:860-533-7270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10296122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist