Fleagle, Jenelle Louise

Fleagle, Jenelle Louise is an individual health care provider with primary practice located at 5509 Bendt Dr Ste 302 , Rapid City SD 57702-9460. She recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / Dentist. Dental Providers / Dentist is her primary health care specialty. Fleagle, Jenelle Louise can be contacted via phone (605) 939-7992.

Contact Information

Primary practice address
5509 Bendt Dr Ste 302 Rapid City SD 57702-9460
Phone: (605) 939-7992
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X D1324 South Dakota
Dental Providers / Dentist 122300000X 30-023733 Ohio

Profile Details

NPI number 1851656375
LBN Legal business name Fleagle, Jenelle Louise
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2012
Last updated Aug 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851656375 NPPES
Ohio MEDICAID 0098381

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