Peter Jengo is a Dentist in Fitchburg, Massachusetts. Peter Jengo practices all healthcare services and medical treatments related to Dentist. The NPI Number for Peter Jengo is 1205985553. The last update date is 2015-08-18.
Peter Jengo's current location address is 326 Nichols Rd, Fitchburg, Massachusetts. You can contact this provider via phone number 9788788516 and fax number 9788788418. The mailing address for Peter Jengo is 326 Nichols Rd, Fitchburg, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Peter Jengo |
|---|---|
| Address | 326 Nichols Rd, Fitchburg, Massachusetts |
| Phone Number | 9788788516 |
| Fax Number | 9788788418 |
| Sole Proprietor | N |
| Credentials | D.D.S |
NPI Number Detail
| NPI Number | 1205985553 |
|---|---|
| Provider Enumeration Date | 2007-01-09 |
| Last Updated Date | 2015-08-18 |
Provider Mailing Address Detail
| Address | 326 Nichols Rd |
|---|---|
| City | Fitchburg |
| State | Massachusetts (MA) |
| Post Code | 1420 |
| Phone Number | 9788788516 |
| Fax Number | 9788788418 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 10648 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 212270 | MA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Peter Jengo?
The Peter Jengo has been issued the NPI (National Provider Identifier) 1205985553 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where Peter Jengo's facilities are situated?
The facilities of Peter Jengo are physically located at the following address: 326 Nichols Rd, Fitchburg, MA, 1420.
What is Peter Jengo's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Peter Jengo is Dentist, and the corresponding taxonomy classification code for this specialized field is 122300000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1205985553 to Peter Jengo?
The Centers for Medicare & Medicaid Services assigned the 1205985553 to Peter Jengo on 2007-01-09.
As of what date was the information pertaining to Peter Jengo, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Peter Jengo, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-08-18.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY