Provider Demographics
NPI:1134245186
Name:KUGAR, JENNIFER (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:KUGAR
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 CUMBERLAND RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7005
Mailing Address - Country:US
Mailing Address - Phone:317-585-8055
Mailing Address - Fax:317-585-9951
Practice Address - Street 1:11501 CUMBERLAND RD
Practice Address - Street 2:SUITE 600
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7005
Practice Address - Country:US
Practice Address - Phone:317-585-8055
Practice Address - Fax:317-585-9951
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120090291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry