Provider Demographics
NPI:1164643011
Name:ADAMS, JEREMY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:LYNN
Last Name:ADAMS
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 1:911 OSLER DR STE D
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4320
Mailing Address - Country:US
Mailing Address - Phone:870-935-6516
Mailing Address - Fax:870-935-0188
Practice Address - Street 1:911 OSLER DR STE D
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4320
Practice Address - Country:US
Practice Address - Phone:870-935-6516
Practice Address - Fax:870-935-0188
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist