Provider Demographics
NPI:1730636259
Name:STEELE, JENNIFER LOREN (DMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOREN
Last Name:STEELE
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 1:13507 PASA ROBLES LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-4848
Mailing Address - Country:US
Mailing Address - Phone:773-720-0729
Mailing Address - Fax:
Practice Address - Street 1:5810 E SAM HOUSTON PKWY N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-2528
Practice Address - Country:US
Practice Address - Phone:281-815-2609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice