Provider Demographics
NPI:1912481102
Name:BINGHAM, TAMMI JEAN (RDH)
Entity type:Individual
Prefix:MRS
First Name:TAMMI
Middle Name:JEAN
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:TAMMI
Other - Middle Name:JEAN
Other - Last Name:RUGGIERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:CMR 411 BOX 6092
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-0061
Mailing Address - Country:US
Mailing Address - Phone:910-676-4105
Mailing Address - Fax:
Practice Address - Street 1:SUDLAGER 301
Practice Address - Street 2:
Practice Address - City:VILSECK
Practice Address - State:AMBERG-SULZBACH
Practice Address - Zip Code:92249
Practice Address - Country:DE
Practice Address - Phone:096-628-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2626124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist