Provider Demographics
NPI:1922639566
Name:KLEPADLO, JACLYN (BSDH, RDH)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:
Last Name:KLEPADLO
Suffix:
Gender:F
Credentials:BSDH, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5429 HARDING HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2263
Mailing Address - Country:US
Mailing Address - Phone:609-625-0505
Mailing Address - Fax:
Practice Address - Street 1:5429 HARDING HWY STE 101
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2263
Practice Address - Country:US
Practice Address - Phone:609-625-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22HI00896200124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist