Provider Demographics
NPI:1740742311
Name:BATO, JESSIE E (RDH)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:E
Last Name:BATO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 BELLEVILLE TPKE
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6463
Mailing Address - Country:US
Mailing Address - Phone:201-991-1228
Mailing Address - Fax:
Practice Address - Street 1:312 BELLEVILLE TPKE
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6463
Practice Address - Country:US
Practice Address - Phone:201-991-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
126800000X
NJ22HI01107400124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No126800000XDental ProvidersDental Assistant