Provider Demographics
NPI:1063608628
Name:DR. DENNIS JAHOVIC & ASSOCIATES,P.C.
Entity type:Organization
Organization Name:DR. DENNIS JAHOVIC & ASSOCIATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:219-942-6979
Mailing Address - Street 1:2621 E 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5761
Mailing Address - Country:US
Mailing Address - Phone:219-942-6979
Mailing Address - Fax:219-942-5125
Practice Address - Street 1:2621 E 80TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5761
Practice Address - Country:US
Practice Address - Phone:219-942-6979
Practice Address - Fax:219-942-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003033A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty