Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | DEN-DEN-LIC-17409 | MT |
N | 213EG0000X | General Practice | DEN-DEN-LIC-17409 | MT |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 17409 | MT |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 63915 | CA |
NPI | 1003239732 |
---|---|
Provider Name | Dr. Jennifer Ann Lehnhardt |
First Address | Bozeman, MT 59718-5617 |
Second Address | Bozeman, MT 59718-5617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2014 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003239732 | (05) | MT |