Provider Demographics
NPI:1356604011
Name:CHRISTY, JENNIFER ELIZABETH NEHODA (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH NEHODA
Last Name:CHRISTY
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:PO BOX 3189
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13220-3189
Mailing Address - Country:US
Mailing Address - Phone:866-273-8204
Mailing Address - Fax:866-803-4943
Practice Address - Street 1:1100 SUNBURY RD
Practice Address - Street 2:UNIT 712
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-6040
Practice Address - Country:US
Practice Address - Phone:740-362-5800
Practice Address - Fax:740-362-0620
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023697122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist