Provider Demographics
NPI:1851687255
Name:RYPEL, JENNIFER KELLY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KELLY
Last Name:RYPEL
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 N GAMMON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3874
Mailing Address - Country:US
Mailing Address - Phone:608-831-5151
Mailing Address - Fax:
Practice Address - Street 1:1001 N GAMMON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3874
Practice Address - Country:US
Practice Address - Phone:608-831-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6994-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice