Provider Demographics
NPI:1770590960
Name:HAMLIN, JEFFREY N (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:N
Last Name:HAMLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 WHITES RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-4801
Mailing Address - Country:US
Mailing Address - Phone:269-385-2101
Mailing Address - Fax:269-385-5908
Practice Address - Street 1:1850 WHITES RD
Practice Address - Street 2:SUITE 2
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-4801
Practice Address - Country:US
Practice Address - Phone:269-385-2101
Practice Address - Fax:269-385-5908
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010184671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP27800 001Medicare ID - Type Unspecified