JESSLYN LENA GRACE HODGE DDS NPI 1679158356

NPI Information

Jesslyn Lena Grace Hodge, DDS is a student in an organized health care education training program in Los Angeles, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Jesslyn Lena Grace Hodge, DDS NPI is 1679158356. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5200 WILSHIRE BLVD APT 494
LOS ANGELES, CA
ZIP 90036-886
Phone: (310) 489-9208

The enumeration date for this NPI number is 3/14/2021 and was last updated on 3/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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