Healthcare Provider Details

I. General information

NPI: 1306047329
Provider Name (Legal Business Name): JAMES JAY HILGERS D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26302 LA PAZ RD STE 202
MISSION VIEJO CA
92691-5328
US

IV. Provider business mailing address

26302 LA PAZ RD STE 202
MISSION VIEJO CA
92691-5328
US

V. Phone/Fax

Practice location:
  • Phone: 949-830-4101
  • Fax: 949-830-0741
Mailing address:
  • Phone: 949-830-4101
  • Fax: 949-830-0741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD21141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: