Healthcare Provider Details
I. General information
NPI: 1235861287
Provider Name (Legal Business Name): HANNAH JEPPESEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2022
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
222 CHAMBLESS LN
HAMILTON GA
31811-6144
US
IV. Provider business mailing address
222 HAMILTON SQ
HAMILTON GA
31811-6087
US
V. Phone/Fax
- Phone: 706-641-0432
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DN122714 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: