Provider Demographics
NPI:1508597931
Name:HAMPTON, MIEKE JONELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIEKE
Middle Name:JONELLE
Last Name:HAMPTON
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 1:970 N BROADWAY STE 306
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1324
Mailing Address - Country:US
Mailing Address - Phone:914-357-8917
Mailing Address - Fax:
Practice Address - Street 1:970 N BROADWAY STE 306
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1324
Practice Address - Country:US
Practice Address - Phone:973-673-4743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02961400122300000X
NY063530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist