Mimms, Jake Ryan

Mimms, Jake Ryan is an individual health care provider with primary practice located at 8263 Madison Blvd Ste A , Madison AL 35758-2051. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Mimms, Jake Ryan can be contacted via phone (256) 774-7228.

Contact Information

Primary practice address
8263 Madison Blvd Ste A Madison AL 35758-2051
Phone: (256) 774-7228
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X 6432 Alabama

Profile Details

NPI number 1700318060
LBN Legal business name Mimms, Jake Ryan
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2017
Last updated Jul 17th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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