Provider Demographics
NPI:1366286916
Name:MORRIS HUMPHREY, JASMYNE M (DDS)
Entity type:Individual
Prefix:DR
First Name:JASMYNE
Middle Name:M
Last Name:MORRIS HUMPHREY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JASMYNE
Other - Middle Name:MARIE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1029 CHIPPEWA AVE NE
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3612
Mailing Address - Country:US
Mailing Address - Phone:701-318-5749
Mailing Address - Fax:
Practice Address - Street 1:121 E FRONT AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5589
Practice Address - Country:US
Practice Address - Phone:701-223-1194
Practice Address - Fax:701-250-9614
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND25091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice