Provider Demographics
NPI:1952435539
Name:NAGY, JETTYE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:JETTYE
Middle Name:L
Last Name:NAGY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JETTYE
Other - Middle Name:L
Other - Last Name:ROGERS-NAGY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:8284 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3153
Mailing Address - Country:US
Mailing Address - Phone:513-231-1012
Mailing Address - Fax:513-231-3925
Practice Address - Street 1:8284 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3153
Practice Address - Country:US
Practice Address - Phone:513-231-1012
Practice Address - Fax:513-231-3925
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20093122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist