Provider Demographics
NPI:1285486282
Name:JENKINS, RAMONE DALE (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMONE
Middle Name:DALE
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 1:4 LOS ANGELES ST APT 2308
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2915
Mailing Address - Country:US
Mailing Address - Phone:702-354-6342
Mailing Address - Fax:
Practice Address - Street 1:4 LOS ANGELES ST APT 2308
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2915
Practice Address - Country:US
Practice Address - Phone:702-354-6342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401419100122300000X
MADN10000362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist