Healthcare Provider Details

I. General information

NPI: 1831188838
Provider Name (Legal Business Name): JAMES J GIFT D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 N DALE MABRY HWY BLDG 801
TAMPA FL
33614-3290
US

IV. Provider business mailing address

8001 N DALE MABRY HWY BLDG 801
TAMPA FL
33614-3290
US

V. Phone/Fax

Practice location:
  • Phone: 813-931-0700
  • Fax: 813-933-8009
Mailing address:
  • Phone: 813-931-0700
  • Fax: 813-933-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN0015411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: