Provider Demographics
NPI:1932656642
Name:SENYSHYN, JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:SENYSHYN
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 1:190 NW SPANISH RIVER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4217
Mailing Address - Country:US
Mailing Address - Phone:561-392-4010
Mailing Address - Fax:561-392-4012
Practice Address - Street 1:190 NW SPANISH RIVER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4217
Practice Address - Country:US
Practice Address - Phone:561-392-4010
Practice Address - Fax:561-392-4012
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN122541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice