Provider Demographics
NPI:1376242651
Name:BLAINE, JAMIE MILLER (RDH)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MILLER
Last Name:BLAINE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 N COURTNEY OAK LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4413
Mailing Address - Country:US
Mailing Address - Phone:865-659-4351
Mailing Address - Fax:
Practice Address - Street 1:1534 N COURTNEY OAK LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938-4413
Practice Address - Country:US
Practice Address - Phone:865-659-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist