MEDICARE: MR. JAMES NIGHBERT ALDRIDGE JR. D.D.S.

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	1223G0001X	General Practice Dentistry	WV2602	WV

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134149834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES NIGHBERT ALDRIDGE JR. D.D.S.

Provider Business Mailing Address
First Line	:	350 5TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1812
Country	:	US
Telephone Number	:	304-523-3666
Fax Number	:	304-623-3762

Provider Business Practice Location Address
First Line	:	350 5TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1812
Country	:	US
Telephone Number	:	304-523-3666
Fax Number	:	304-623-3762

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/09/2007

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Directions to “ MR. JAMES NIGHBERT ALDRIDGE JR. D.D.S.” Practice Location

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