Provider Demographics
NPI:1033854740
Name:JMJ HOLDING LLC
Entity Type:Organization
Organization Name:JMJ HOLDING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE OPTIMIZATION ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-508-5946
Mailing Address - Street 1:914 12TH AVE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5735
Mailing Address - Country:US
Mailing Address - Phone:208-996-3010
Mailing Address - Fax:
Practice Address - Street 1:914 12TH AVE RD STE 102
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5735
Practice Address - Country:US
Practice Address - Phone:208-996-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JMJ HOLDING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty