Provider Demographics
NPI:1285086645
Name:CARTWRIGHT, JEFF (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1506
Mailing Address - Country:US
Mailing Address - Phone:765-482-4538
Mailing Address - Fax:616-850-3976
Practice Address - Street 1:1911 N LEBANON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-1506
Practice Address - Country:US
Practice Address - Phone:765-482-4538
Practice Address - Fax:765-484-8681
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012599B1223G0001X
MI29010220141223G0001X
IN12012599A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice