Secrest, Jennifer Erin

Secrest, Jennifer Erin is an individual health care provider with primary practice located at 200 Don Allen Rd , Louisville KY 40207-3910. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is her primary health care specialty. Secrest, Jennifer Erin can be contacted via phone (502) 727-4974.

Contact Information

Primary practice address
200 Don Allen Rd Louisville KY 40207-3910
Phone: (502) 727-4974
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12010855A Indiana
Dental Providers / Pediatric Dentistry 1223P0221X 8399 Kentucky
Dental Providers / General Practice 1223G0001X 8399 Kentucky

Profile Details

NPI number 1033270657
LBN Legal business name Secrest, Jennifer Erin
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jul 12th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033270657 NPPES
Indiana MEDICAID 200835020

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