Provider Demographics
NPI:1942448642
Name:DOSS, JERRILEE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERRILEE
Middle Name:ANN
Last Name:DOSS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:RODEO
Mailing Address - State:CA
Mailing Address - Zip Code:94572-1126
Mailing Address - Country:US
Mailing Address - Phone:510-799-4871
Mailing Address - Fax:
Practice Address - Street 1:301 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:RODEO
Practice Address - State:CA
Practice Address - Zip Code:94572-1126
Practice Address - Country:US
Practice Address - Phone:510-799-4871
Practice Address - Fax:510-799-4534
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36654122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist