Healthcare Provider Details

I. General information

NPI: 1841376407
Provider Name (Legal Business Name): JAMES HOLTER SINKS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 GENESEE AVE SUITE 203
SAN DIEGO CA
92117-4900
US

IV. Provider business mailing address

4320 GENESEE AVE STE 203
SAN DIEGO CA
92117-4900
US

V. Phone/Fax

Practice location:
  • Phone: 858-541-7676
  • Fax: 858-541-1174
Mailing address:
  • Phone: 858-541-7676
  • Fax: 858-541-1174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number28625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: