Provider Demographics
NPI:1942827654
Name:ROMINE, JARRETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:
Last Name:ROMINE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 SW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66610-1367
Mailing Address - Country:US
Mailing Address - Phone:785-249-7798
Mailing Address - Fax:
Practice Address - Street 1:1919 SW 10TH AVE #102
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604
Practice Address - Country:US
Practice Address - Phone:785-232-7707
Practice Address - Fax:985-232-9129
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist