Provider Demographics
NPI:1831399302
Name:ROBLES-VELEZ, JENNIBETH (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNIBETH
Middle Name:
Last Name:ROBLES-VELEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TEA OLIVE COURT
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803
Mailing Address - Country:US
Mailing Address - Phone:803-226-9472
Mailing Address - Fax:803-648-0057
Practice Address - Street 1:20 TEA OLIVE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-4715
Practice Address - Country:US
Practice Address - Phone:803-226-9472
Practice Address - Fax:803-648-0057
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD69551223S0112X
SC69551223S0112X
IL0190274611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery