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Dr. Jake Ryan Mimms, DMD
General Practice Dentistry in Madison, Alabama
NPI 1700318060

Jake Ryan Mimms is a General Practice Dentistry based in Madison, AL and is specialized in General Practice. Jake Ryan Mimms practices in Madison, AL and has the professional credentials of DMD. The NPI Number for Jake Ryan Mimms is 1700318060 and holds a License No. (Alabama).

The current practice location address for Jake Ryan Mimms is 8263 Madison Blvd Ste A, Madison, AL and can be reached out via phone at 256-774-7228. You can also correspond with Jake Ryan Mimms through the mailing address at 8263 MADISON BLVD STE A, MADISON, AL - 35758-2051 (mailing address contact number: 256-774-7228).

Location: 8263 Madison Blvd Ste A, Madison, AL, 35758-2051
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700318060
Provider Name
Jake Ryan Mimms
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
8263 Madison Blvd Ste A, Madison, AL, 35758-2051
Phone Number
256-774-7228
Fax Number
Provider Enumeration Date
03/28/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8263 Madison Blvd Ste A
City
Madison
State
Alabama
Zip
35758-2051
Phone Number
256-774-7228
Fax Number
person
Provider Business Mailing Address Details
Address
8263 Madison Blvd Ste A
City
Madison
State
Alabama
Zip
35758-2051
Phone Number
256-774-7228
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
6432 (Alabama)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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