Provider Demographics
NPI:1740419217
Name:DIPIERO, JENNIFER M (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:DIPIERO
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 1:1376 N PORTAGE PATH
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5848
Mailing Address - Country:US
Mailing Address - Phone:330-867-9494
Mailing Address - Fax:330-867-9492
Practice Address - Street 1:1376 N PORTAGE PATH
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5848
Practice Address - Country:US
Practice Address - Phone:330-867-9494
Practice Address - Fax:330-867-9492
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0230331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice