MEDICARE: DR. KIMBERLY L HANNAH-JONES D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN0012708	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881938850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY L HANNAH-JONES D.M.D.

Provider Business Mailing Address
First Line	:	11213 N NEBRASKA AVE
Second Line	:	SUITE 406C
City	:	TAMPA
State	:	FL
Zip	:	33612-5775
Country	:	US
Telephone Number	:	813-977-4819
Fax Number	:	813-977-4568

Provider Business Practice Location Address
First Line	:	11213 N NEBRASKA AVE
Second Line	:	SUITE 406C
City	:	TAMPA
State	:	FL
Zip	:	33612-5775
Country	:	US
Telephone Number	:	813-977-4819
Fax Number	:	813-977-4568

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	11/15/2012

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