Healthcare Provider Details

I. General information

NPI: 1699078469
Provider Name (Legal Business Name): JAMI S OPALEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 S CEDAR ST
LANSING MI
48911-3800
US

IV. Provider business mailing address

2815 S PENNSYLVANIA AVE
LANSING MI
48910-3495
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-4311
  • Fax: 517-887-4310
Mailing address:
  • Phone: 517-272-4150
  • Fax: 517-485-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: