Provider Demographics
NPI:1598475162
Name:HINKES, JACQUELINE ANNETTE (RDH)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:ANNETTE
Last Name:HINKES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MS
Other - First Name:JACQUELINE
Other - Middle Name:ANNETTE
Other - Last Name:DABROWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:4922 W NORWICH CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2720
Mailing Address - Country:US
Mailing Address - Phone:414-795-8850
Mailing Address - Fax:
Practice Address - Street 1:711 W MORELAND BLVD # 204
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-2483
Practice Address - Country:US
Practice Address - Phone:262-896-9891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11031-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist