Provider Demographics
NPI:1225412968
Name:JENKINS, JASMINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 MONUMENT BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3972
Mailing Address - Country:US
Mailing Address - Phone:925-363-4455
Mailing Address - Fax:
Practice Address - Street 1:2380 MONUMENT BLVD STE F
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3972
Practice Address - Country:US
Practice Address - Phone:925-363-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102527122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist