Healthcare Provider Details

I. General information

NPI: 1275765919
Provider Name (Legal Business Name): JAMES M. DAYLEY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JAMES MILES DAYLEY DMD

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 CARDINAL AVE
FOUNTAIN VALLEY CA
92708-6326
US

IV. Provider business mailing address

8900 CARDINAL AVE
FOUNTAIN VALLEY CA
92708-6326
US

V. Phone/Fax

Practice location:
  • Phone: 805-403-2676
  • Fax:
Mailing address:
  • Phone: 805-403-2676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7405372-9921
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number64567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: