Provider Demographics
NPI:1114784691
Name:KEMPER, JAMIE CAROL (RDH)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:CAROL
Last Name:KEMPER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:CAROL
Other - Last Name:KEMPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:249 WENDOVER RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-3138
Mailing Address - Country:US
Mailing Address - Phone:207-717-9556
Mailing Address - Fax:
Practice Address - Street 1:THE UNITED STATES COAST GUARD YARD
Practice Address - Street 2:2401 HAWKINS POINT RD
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21226-5000
Practice Address - Country:US
Practice Address - Phone:207-717-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8825124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist