Provider Demographics
NPI:1548634231
Name:JHUTY, RENA (DMD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:
Last Name:JHUTY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 SE 245TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-9204
Mailing Address - Country:US
Mailing Address - Phone:206-954-9905
Mailing Address - Fax:
Practice Address - Street 1:11911 SE 245TH PL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-9204
Practice Address - Country:US
Practice Address - Phone:206-954-9905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60608752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist