Provider Demographics
NPI:1619197456
Name:JENKS, JULIE ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:JENKS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5170 SALT LICK TWP ROAD 191
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OH
Mailing Address - Zip Code:43782
Mailing Address - Country:US
Mailing Address - Phone:740-342-4156
Mailing Address - Fax:
Practice Address - Street 1:257 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1060
Practice Address - Country:US
Practice Address - Phone:740-342-4156
Practice Address - Fax:740-342-4156
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH218201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice