Provider Demographics
NPI:1699106682
Name:DEMPSEY, JERROD (D,MD)
Entity type:Individual
Prefix:DR
First Name:JERROD
Middle Name:
Last Name:DEMPSEY
Suffix:
Gender:M
Credentials:D,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 N GRAND AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-4107
Mailing Address - Country:US
Mailing Address - Phone:859-441-2369
Mailing Address - Fax:
Practice Address - Street 1:40 N GRAND AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-4107
Practice Address - Country:US
Practice Address - Phone:859-441-2369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics