Provider Demographics
NPI:1720341704
Name:SILVERMAN, JEREMY A (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:A
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 W CHANDLER BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2531
Mailing Address - Country:US
Mailing Address - Phone:480-608-5444
Mailing Address - Fax:480-608-5445
Practice Address - Street 1:936 W CHANDLER BLVD STE 2
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2531
Practice Address - Country:US
Practice Address - Phone:480-608-5444
Practice Address - Fax:480-608-5445
Is Sole Proprietor?:No
Enumeration Date:2012-06-24
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0084671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice