Provider Demographics
NPI:1770021669
Name:PAUL, JENCY (DMD)
Entity Type:Individual
Prefix:
First Name:JENCY
Middle Name:
Last Name:PAUL
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 1:5 STRATHMORE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-7023
Mailing Address - Country:US
Mailing Address - Phone:845-641-7795
Mailing Address - Fax:
Practice Address - Street 1:1060 MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2591
Practice Address - Country:US
Practice Address - Phone:201-342-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026758001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice