Provider Demographics
NPI:1952539512
Name:JIMENEZ, ARLEEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARLEEN
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 OLD NORCROSS RD
Mailing Address - Street 2:STE 303
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1740
Mailing Address - Country:US
Mailing Address - Phone:678-584-8778
Mailing Address - Fax:678-584-8755
Practice Address - Street 1:3780 OLD NORCROSS RD
Practice Address - Street 2:STE 303
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1740
Practice Address - Country:US
Practice Address - Phone:678-584-8778
Practice Address - Fax:678-584-8755
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0140281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice