Provider Demographics
NPI:1912129487
Name:MASTER, JITEN JASHWANT (DDS, MS)
Entity Type:Individual
Prefix:MR
First Name:JITEN
Middle Name:JASHWANT
Last Name:MASTER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3023 EASTLAND BLVD
Mailing Address - Street 2:BLDG H, SUITE 112
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-4106
Mailing Address - Country:US
Mailing Address - Phone:727-797-5161
Mailing Address - Fax:727-797-5121
Practice Address - Street 1:3023 EASTLAND BLVD
Practice Address - Street 2:BLDG H, SUITE 112
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4106
Practice Address - Country:US
Practice Address - Phone:717-797-5161
Practice Address - Fax:727-797-5121
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHDN14335122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist