Provider Demographics
NPI:1366127185
Name:LOZADA, JENNIFER YASHIRA (RDH, DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:YASHIRA
Last Name:LOZADA
Suffix:
Gender:F
Credentials:RDH, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 BEECHMONT ST
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1331
Mailing Address - Country:US
Mailing Address - Phone:617-898-8680
Mailing Address - Fax:
Practice Address - Street 1:256 ASHMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02124-3804
Practice Address - Country:US
Practice Address - Phone:617-282-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist