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General NPI Number Information
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NPI Number | 1598312126
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Entity Type | Individual
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Provider Name | JASMINE ROXANNA FLAKE-WARMOTH DDS
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Gender | Female
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 500 SPRUCE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2666
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Country | US
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Telephone | 415-221-1788
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TOWNSEND ST APT 2-1005
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-4010
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Country | US
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Telephone | 650-492-0098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 103984
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License Number State | CA
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