Provider Demographics
NPI:1356769095
Name:SINICK, JESSICA LEA (DDS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEA
Last Name:SINICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:LEA
Other - Last Name:GOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5115 RIVER STYX RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256
Mailing Address - Country:US
Mailing Address - Phone:330-725-9851
Mailing Address - Fax:330-764-3070
Practice Address - Street 1:5115 RIVER STYX RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256
Practice Address - Country:US
Practice Address - Phone:330-725-9851
Practice Address - Fax:330-764-3070
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0 24130122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist