Provider Demographics
NPI:1790995082
Name:FLOWERS, JAMAL RAMON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:RAMON
Last Name:FLOWERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7525 153RD ST APT 504
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3094
Mailing Address - Country:US
Mailing Address - Phone:917-756-8498
Mailing Address - Fax:
Practice Address - Street 1:1103 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4886
Practice Address - Country:US
Practice Address - Phone:516-222-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051782-11223E0200X
MI29010187721223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics