Provider Demographics
NPI:1912007667
Name:KERN, JEANETTE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:M
Last Name:KERN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 FOREST RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4101
Mailing Address - Country:US
Mailing Address - Phone:831-375-6514
Mailing Address - Fax:
Practice Address - Street 1:660 CAMINO AGUAJITO
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3654
Practice Address - Country:US
Practice Address - Phone:831-372-8011
Practice Address - Fax:831-372-1090
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice