Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JERROD LYNN SANDERS, DDS
Active Sole ProprietorDR. JERROD LYNN SANDERS, DDS is a Pediatric Dentistry healthcare provider located in FORT CAMPBELL, Kentucky. NPI 1245200104 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · FORT CAMPBELL, KY
Registration Details
- NPI Number
- 1245200104
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 24, 2006 (20.56377655223 yrs)
- Last Updated
- Mar 27, 2023
- Licenses
-
0021321 (TX)21321 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5979 DESERT STORM AVEFORT CAMPBELL, KY, 422235514Browse KY providers · Browse ZIP 42223
- Phone
- 2704128563
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
- Additional Specialty
- Pediatric Dentistry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.