Provider Demographics
NPI:1437992757
Name:HELMKAMP, JAXSEN JAMES ARTHUR (DMD)
Entity type:Individual
Prefix:DR
First Name:JAXSEN
Middle Name:JAMES ARTHUR
Last Name:HELMKAMP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 GERBER RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3119
Mailing Address - Country:US
Mailing Address - Phone:618-570-9735
Mailing Address - Fax:
Practice Address - Street 1:1203 W DELMAR AVE
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-1739
Practice Address - Country:US
Practice Address - Phone:618-466-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019035176122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist