Provider Demographics
NPI:1124031133
Name:FLAMME, JEFFREY LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEE
Last Name:FLAMME
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 1:396 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4717
Mailing Address - Country:US
Mailing Address - Phone:908-273-1337
Mailing Address - Fax:908-273-0157
Practice Address - Street 1:396 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-4717
Practice Address - Country:US
Practice Address - Phone:908-273-1337
Practice Address - Fax:908-273-0157
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 156241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ718083Medicare ID - Type UnspecifiedMEDICARE