Provider Demographics
NPI:1033490941
Name:OLIVO, JEANNIE ARLENE (DDS)
Entity type:Individual
Prefix:DR
First Name:JEANNIE
Middle Name:ARLENE
Last Name:OLIVO
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 THE 12TH FAIRWAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5934
Mailing Address - Country:US
Mailing Address - Phone:718-812-1097
Mailing Address - Fax:
Practice Address - Street 1:8961 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1826
Practice Address - Country:US
Practice Address - Phone:561-486-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0558051223G0001X
FLDN278521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice