Provider Demographics
NPI:1871714105
Name:ROGERS, JESSICA FAYE (DDS)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:FAYE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:FAYE
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2940 NEWMARKET ST
Mailing Address - Street 2:STE 101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226
Mailing Address - Country:US
Mailing Address - Phone:360-733-1334
Mailing Address - Fax:360-734-8045
Practice Address - Street 1:2940 NEWMARKET ST
Practice Address - Street 2:STE 101
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226
Practice Address - Country:US
Practice Address - Phone:360-733-1334
Practice Address - Fax:360-734-8045
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist