1558367904 NPI number — DR. JENNIFER FRANCES MCFINTON DDS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558367904 NPI number — DR. JENNIFER FRANCES MCFINTON DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCFINTON
Provider First Name:
JENNIFER
Provider Middle Name:
FRANCES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DIBBLE
Provider Other First Name:
JOHN
Provider Other Middle Name:
MICHAEL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1558367904
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/21/2006
NPI Reactivation Date:
03/28/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 N ANN ARBOR ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48176-1011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-429-4111
Provider Business Mailing Address Fax Number:
734-429-9478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 N ANN ARBOR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48176-1011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-429-4111
Provider Business Practice Location Address Fax Number:
734-429-9478
Provider Enumeration Date:
06/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  18168 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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