Provider Demographics
NPI:1700319423
Name:BRECKSVILLE KIDS DENTISTRY
Entity Type:Organization
Organization Name:BRECKSVILLE KIDS DENTISTRY
Other - Org Name:JENNIFER BRYK HECHKO, DDS, MS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BRYK
Authorized Official - Last Name:HECHKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:440-665-8825
Mailing Address - Street 1:2711 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-3312
Mailing Address - Country:US
Mailing Address - Phone:440-665-8825
Mailing Address - Fax:
Practice Address - Street 1:8801 BRECKSVILLE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1947
Practice Address - Country:US
Practice Address - Phone:440-838-5445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0218041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty