Provider Demographics
NPI:1922269729
Name:JAREMUS, KENT MICHAEL (DDS)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:MICHAEL
Last Name:JAREMUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:KENT
Other - Middle Name:MICHAEL
Other - Last Name:JAREMUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:245 N RAND RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2278
Mailing Address - Country:US
Mailing Address - Phone:847-438-3530
Mailing Address - Fax:847-438-3542
Practice Address - Street 1:245 N RAND RD
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2278
Practice Address - Country:US
Practice Address - Phone:847-438-3530
Practice Address - Fax:847-438-3542
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A176291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice