Provider Demographics
NPI:1407436017
Name:SESI, JASMINE ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:ELIZABETH
Last Name:SESI
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 1:44170 W 12 MILE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2650
Mailing Address - Country:US
Mailing Address - Phone:248-553-9393
Mailing Address - Fax:
Practice Address - Street 1:44170 W 12 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2650
Practice Address - Country:US
Practice Address - Phone:248-553-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600873122300000X
MI2901600873APP21122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist