Provider Demographics
NPI:1962549063
Name:SAVEL, JEROME JAY (DMD)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:JAY
Last Name:SAVEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 KILKENNY PL
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-7708
Mailing Address - Country:US
Mailing Address - Phone:510-421-3961
Mailing Address - Fax:
Practice Address - Street 1:3715 RAILROAD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5236
Practice Address - Country:US
Practice Address - Phone:925-439-2588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB2984801Medicaid