Provider Demographics
NPI:1609979061
Name:WARNER, JAMI LYNN (DDS)
Entity Type:Individual
Prefix:MS
First Name:JAMI
Middle Name:LYNN
Last Name:WARNER
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:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:IN
Mailing Address - Zip Code:46031
Mailing Address - Country:US
Mailing Address - Phone:765-292-2366
Mailing Address - Fax:765-292-2081
Practice Address - Street 1:29101 ST RD 19
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:IN
Practice Address - Zip Code:46031
Practice Address - Country:US
Practice Address - Phone:765-292-2366
Practice Address - Fax:765-292-2081
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist