Individual
JENNEATE RADIX-GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-6552
Mailing address
110 W 97TH ST, NEW YORK, NY 10025-6450
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
061516-01
NY
2255A2300X
Athletic Trainer
—
NY
Other
Enumeration date
06/02/2019
Last updated
01/27/2026
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