Provider Demographics
NPI:1124519350
Name:JENKINS, THOMAS DRISKILL (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DRISKILL
Last Name:JENKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 HWY 5 N
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72019-9031
Mailing Address - Country:US
Mailing Address - Phone:501-847-7070
Mailing Address - Fax:
Practice Address - Street 1:3310 HWY 5 N
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72019-9031
Practice Address - Country:US
Practice Address - Phone:501-847-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR43591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry