Provider Demographics
NPI:1841875606
Name:HECHT, JENNIFER (DMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HECHT
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 1:4607 SPRINGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-4809
Mailing Address - Country:US
Mailing Address - Phone:480-760-1744
Mailing Address - Fax:
Practice Address - Street 1:350 W MCLELLAN RD UNIT 9
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2262
Practice Address - Country:US
Practice Address - Phone:480-760-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-13
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZD011124122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program