Healthcare Provider Details

I. General information

NPI: 1134229446
Provider Name (Legal Business Name): JAMES BERNARD FLYNN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 CROCKER ROAD SUITE 130
WESTLAKE OH
44145
US

IV. Provider business mailing address

2237 CROCKER ROAD SUITE 130
WESTLAKE OH
44145
US

V. Phone/Fax

Practice location:
  • Phone: 440-899-7188
  • Fax: 440-899-1288
Mailing address:
  • Phone: 440-899-7188
  • Fax: 440-899-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number21670
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: