Provider Demographics
NPI:1003264508
Name:HOFFMAN, JAMESON EVERETT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMESON
Middle Name:EVERETT
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PANZER KASERNE BLDG 2996
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09046
Mailing Address - Country:US
Mailing Address - Phone:314-590-1664
Mailing Address - Fax:314-590-2881
Practice Address - Street 1:PANZER KASERNE BLDG 2996
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09046
Practice Address - Country:US
Practice Address - Phone:314-590-1664
Practice Address - Fax:314-590-2881
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9790047-99211223G0001X, 122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist