Provider Demographics
NPI:1154578813
Name:HATCHER, JENIKA NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:JENIKA
Middle Name:NICOLE
Last Name:HATCHER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ALHAMBRA AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3156
Mailing Address - Country:US
Mailing Address - Phone:925-370-5955
Mailing Address - Fax:925-370-5142
Practice Address - Street 1:13601 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3818
Practice Address - Country:US
Practice Address - Phone:510-231-9540
Practice Address - Fax:925-231-8663
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist