Provider Demographics
NPI:1609002732
Name:STRIMER, JENNIFER MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:STRIMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 573
Mailing Address - Street 2:
Mailing Address - City:ST. MARYS
Mailing Address - State:WV
Mailing Address - Zip Code:26170
Mailing Address - Country:US
Mailing Address - Phone:304-684-7200
Mailing Address - Fax:304-684-3760
Practice Address - Street 1:111 LAFAYETTE ST.
Practice Address - Street 2:SUITE 203
Practice Address - City:ST. MARYS
Practice Address - State:WV
Practice Address - Zip Code:26170
Practice Address - Country:US
Practice Address - Phone:304-684-7200
Practice Address - Fax:304-684-3760
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV38571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810015895Medicare PIN