Provider Demographics
NPI:1316091390
Name:TIMMONS, JASON ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ERIC
Last Name:TIMMONS
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 1:315 N BOWMAN
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211
Mailing Address - Country:US
Mailing Address - Phone:501-223-3758
Mailing Address - Fax:501-223-3750
Practice Address - Street 1:315 N BOWMAN
Practice Address - Street 2:SUITE 5
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211
Practice Address - Country:US
Practice Address - Phone:501-223-3758
Practice Address - Fax:501-223-3750
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics