Provider Demographics
NPI:1649873639
Name:GIVENS, JOCELYN TERIKA (RDH)
Entity type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:TERIKA
Last Name:GIVENS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 GOLF BROOK CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-6114
Mailing Address - Country:US
Mailing Address - Phone:850-867-8216
Mailing Address - Fax:
Practice Address - Street 1:520 W HIGHWAY 436 STE 1118
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-4000
Practice Address - Country:US
Practice Address - Phone:407-862-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH24772124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist