Provider Demographics
NPI:1720217300
Name:LOVELAND, JARED JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:JAMES
Last Name:LOVELAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9660 E 22ND ST STE 160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-7562
Mailing Address - Country:US
Mailing Address - Phone:520-917-0666
Mailing Address - Fax:
Practice Address - Street 1:9660 E 22ND ST STE 160
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-7562
Practice Address - Country:US
Practice Address - Phone:520-917-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-05
Last Update Date:2009-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD78111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice