Provider Demographics
NPI:1821053497
Name:HAMILTON, JESS M JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESS
Middle Name:M
Last Name:HAMILTON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1414 GREEN OAK TERRACE CT
Mailing Address - Street 2:SUITE 400
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2960
Mailing Address - Country:US
Mailing Address - Phone:281-359-1011
Mailing Address - Fax:281-358-1085
Practice Address - Street 1:1414 GREEN OAK TERRACE CT
Practice Address - Street 2:SUITE 400
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77339-2960
Practice Address - Country:US
Practice Address - Phone:281-359-1011
Practice Address - Fax:281-358-1085
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00ET60OtherBCBS
TXT13654Medicare UPIN