MEDICARE: ROBERT D JAMES DDS INC

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	19751	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19751	OTHER	CA	STATE LICENSE #

General Provider Information

NPI Number	:	1447397880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT D JAMES DDS INC

Provider Business Mailing Address
First Line	:	412 W BASELINE RD
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-1607
Country	:	US
Telephone Number	:	909-621-4862
Fax Number	:	909-621-3415

Provider Business Practice Location Address
First Line	:	412 W BASELINE RD
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-1607
Country	:	US
Telephone Number	:	909-621-4862
Fax Number	:	909-621-3415

Authorized Official
Title or Position	:	PRESTREAS
Name	:	DR. ROBERT DOUGLAS JAMES
Credential	:	DDS
Telephone Number	:	909-621-4862

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	08/22/2020

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