Healthcare Provider Details

I. General information

NPI: 1598911653
Provider Name (Legal Business Name): JAIME LEE JAMES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 07/26/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC
FPO AP
96375
US

IV. Provider business mailing address

OKINAWA NAVAL HOSPITAL
FPO AP
96375
US

V. Phone/Fax

Practice location:
  • Phone: 98-971-9355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD-5041
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: