Provider Demographics
NPI:1659994309
Name:CROMARTIE-HICKS, JAZMIN ARIELLE (DMD)
Entity type:Individual
Prefix:MRS
First Name:JAZMIN
Middle Name:ARIELLE
Last Name:CROMARTIE-HICKS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JAZMIN
Other - Middle Name:ARIELLE
Other - Last Name:CROMARTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1634 N MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262
Mailing Address - Country:US
Mailing Address - Phone:336-841-9198
Mailing Address - Fax:
Practice Address - Street 1:1634 N MAIN ST.
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262
Practice Address - Country:US
Practice Address - Phone:336-841-9198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC118141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice