Provider Demographics
NPI:1275279788
Name:CUMMINGS, JANNAH (DDS)
Entity Type:Individual
Prefix:
First Name:JANNAH
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E ALEXANDRINE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2011
Mailing Address - Country:US
Mailing Address - Phone:313-416-6262
Mailing Address - Fax:313-221-8217
Practice Address - Street 1:101 E ALEXANDRINE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2011
Practice Address - Country:US
Practice Address - Phone:313-416-6262
Practice Address - Fax:313-221-8217
Is Sole Proprietor?:No
Enumeration Date:2022-05-08
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601459122300000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes122300000XDental ProvidersDentist