Healthcare Provider Details

I. General information

NPI: 1215196407
Provider Name (Legal Business Name): JAMES FRANK KING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J FRANK KING DDS

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 04/27/2021
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4317 E MCDOWELL RD
PHOENIX AZ
85008-4501
US

IV. Provider business mailing address

3022 E GLENCOVE CIR
MESA AZ
85213-4228
US

V. Phone/Fax

Practice location:
  • Phone: 602-633-0405
  • Fax: 480-654-0705
Mailing address:
  • Phone: 480-390-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD010928
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4215
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: