Provider Demographics
NPI:1245541697
Name:JENKINS, AARON CHRISTOPHER (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:CHRISTOPHER
Last Name:JENKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 PAOLI PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9696
Mailing Address - Country:US
Mailing Address - Phone:812-923-2200
Mailing Address - Fax:
Practice Address - Street 1:4801 PAOLI PIKE
Practice Address - Street 2:SUITE 102
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9696
Practice Address - Country:US
Practice Address - Phone:812-923-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011466A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist