Healthcare Provider Details

I. General information

NPI: 1497839930
Provider Name (Legal Business Name): JAMES R SCOTT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MAIN ST
OLATHE CO
81425
US

IV. Provider business mailing address

PO BOX 528
OLATHE CO
81425-0528
US

V. Phone/Fax

Practice location:
  • Phone: 970-323-6828
  • Fax: 970-323-6186
Mailing address:
  • Phone: 970-323-6828
  • Fax: 970-323-6186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number106268
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: