Provider Demographics
NPI:1568457620
Name:DYKES, JANA NMN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:NMN
Last Name:DYKES
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:UNIT 3865
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09126
Mailing Address - Country:DE
Mailing Address - Phone:004-965-6169
Mailing Address - Fax:
Practice Address - Street 1:UNIT 3865
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09126
Practice Address - Country:DE
Practice Address - Phone:004-965-6169
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice