Provider Demographics
NPI:1477664118
Name:JENKINS, JAMES G
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:JENKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CROSSINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-7840
Mailing Address - Country:US
Mailing Address - Phone:843-384-6328
Mailing Address - Fax:
Practice Address - Street 1:7400 ABERCORN ST STE 813
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2455
Practice Address - Country:US
Practice Address - Phone:912-542-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4414122300000X
GA010143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist