Provider Demographics
NPI:1427061803
Name:MURPHY, JENNIFER (DDS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MURPHY
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 1:39165 WOODLAND TRL
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-5729
Mailing Address - Country:US
Mailing Address - Phone:440-840-4012
Mailing Address - Fax:
Practice Address - Street 1:1495 COOPER FOSTER PARK RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1202
Practice Address - Country:US
Practice Address - Phone:440-282-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist