Provider Demographics
NPI:1932223823
Name:HILDEBRANDT, JEFFREY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOSEPH
Last Name:HILDEBRANDT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17535 ROSBOUGH BLVD
Mailing Address - Street 2:#203
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-8361
Mailing Address - Country:US
Mailing Address - Phone:440-243-8888
Mailing Address - Fax:440-243-4575
Practice Address - Street 1:17535 ROSBOUGH BLVD
Practice Address - Street 2:#203
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8361
Practice Address - Country:US
Practice Address - Phone:440-243-8888
Practice Address - Fax:440-243-4575
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH218291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice