Provider Demographics
NPI:1922636497
Name:ZHOU, JESSIE KAREN (DMD)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:KAREN
Last Name:ZHOU
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 1:4380 HAMMOCKS DR
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-9598
Mailing Address - Country:US
Mailing Address - Phone:215-432-5040
Mailing Address - Fax:
Practice Address - Street 1:25 RED JACKET ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9517
Practice Address - Country:US
Practice Address - Phone:585-335-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist