Provider Demographics
NPI:1881614600
Name:FORSHEY, JENNIFER N (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:N
Last Name:FORSHEY
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 BALTIMORE BLVD
Mailing Address - Street 2:UNIT C-1
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7098
Mailing Address - Country:US
Mailing Address - Phone:410-982-0650
Mailing Address - Fax:410-982-0655
Practice Address - Street 1:1130 BALTIMORE BLVD
Practice Address - Street 2:UNIT C-1
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7098
Practice Address - Country:US
Practice Address - Phone:410-982-0650
Practice Address - Fax:410-982-0655
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137601223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011477340001Medicaid
MD205396Medicaid
MD205396Medicaid
PAV03207Medicare UPIN