Provider Demographics
NPI:1851443527
Name:JARECKI, JESSICA L (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:JARECKI
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 1:1001 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17405
Mailing Address - Country:US
Mailing Address - Phone:717-851-2066
Mailing Address - Fax:717-851-3565
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17405
Practice Address - Country:US
Practice Address - Phone:717-851-2655
Practice Address - Fax:717-851-3565
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0364941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101633988Medicaid