Kirshbaum, Jaclyn
Kirshbaum, Jaclyn is an sole proprietor health care provider with primary practice located at 12165 Elm St , Princess Anne MD 21853-1358. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Kirshbaum, Jaclyn can be contacted via phone (410) 651-5151.Contact Information
Primary practice address
12165 Elm St
Princess Anne MD 21853-1358
Phone: (410) 651-5151
Fax: (410) 651-4256
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Dental Providers / Pediatric Dentistry | 1223P0221X | LL908 | Maryland |
Profile Details
| NPI number | 1598419079 |
|---|---|
| LBN Legal business name | Kirshbaum, Jaclyn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 4th, 2022 |
| Last updated | Jun 16th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598419079 | NPPES |
| Maryland | MEDICAID | 119591300 |
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