Provider Demographics
NPI:1558106104
Name:BENJAMIN S. JAMO DDS, PLLC
Entity type:Organization
Organization Name:BENJAMIN S. JAMO DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAMO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-339-1012
Mailing Address - Street 1:335 W LAKE LANSING RD STE 200
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8486
Mailing Address - Country:US
Mailing Address - Phone:517-339-1012
Mailing Address - Fax:
Practice Address - Street 1:335 W LAKE LANSING RD STE 200
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8486
Practice Address - Country:US
Practice Address - Phone:517-339-1012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty