Provider Demographics
NPI:1336843986
Name:DAIBER, JESSICA ANN (DDS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:DAIBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4869 ESSEXSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-5626
Mailing Address - Country:US
Mailing Address - Phone:214-663-0714
Mailing Address - Fax:
Practice Address - Street 1:1908 EXETER RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2971
Practice Address - Country:US
Practice Address - Phone:901-759-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4825122300000X
TN12779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist