Provider Demographics
NPI:1427480920
Name:SCHARES, JENNA LEA (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:LEA
Last Name:SCHARES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JENNA
Other - Middle Name:LEA
Other - Last Name:CHASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:11 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:OELWEIN
Mailing Address - State:IA
Mailing Address - Zip Code:50662-1752
Mailing Address - Country:US
Mailing Address - Phone:319-283-4738
Mailing Address - Fax:319-283-4754
Practice Address - Street 1:11 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662
Practice Address - Country:US
Practice Address - Phone:319-283-4738
Practice Address - Fax:319-283-4754
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130173061223G0001X
IADDS-094711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice