Provider Demographics
NPI:1013003847
Name:OCAMPO, JAIME ANDRES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ANDRES
Last Name:OCAMPO
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 1:100 MINGES CREEK PLACE E302
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015
Mailing Address - Country:US
Mailing Address - Phone:734-355-8203
Mailing Address - Fax:
Practice Address - Street 1:8 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MI
Practice Address - Zip Code:49082
Practice Address - Country:US
Practice Address - Phone:517-639-7151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018351122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist