Healthcare Provider Details

I. General information

NPI: 1326060112
Provider Name (Legal Business Name): RICHARD DON JAMES D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 NW 63RD ST STE B
OKLAHOMA CITY OK
73116-2041
US

IV. Provider business mailing address

3621 NW 63RD ST STE B
OKLAHOMA CITY OK
73116-2041
US

V. Phone/Fax

Practice location:
  • Phone: 405-848-2884
  • Fax: 405-848-3249
Mailing address:
  • Phone: 405-848-2884
  • Fax: 405-848-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3272
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: