Provider Demographics
NPI:1962610675
Name:JAMEEL, JESSICA (DDS)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:JAMEEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4037 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2257
Mailing Address - Country:US
Mailing Address - Phone:248-939-3842
Mailing Address - Fax:
Practice Address - Street 1:32905 W 12 MILE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3342
Practice Address - Country:US
Practice Address - Phone:248-489-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist