Healthcare Provider Details

I. General information

NPI: 1730525809
Provider Name (Legal Business Name): MICHAEL ANTHONY JAMES D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 EXETER RD STE 2
GERMANTOWN TN
38138-3965
US

IV. Provider business mailing address

1271 ISLAND HARBOR DR
MEMPHIS TN
38103-8998
US

V. Phone/Fax

Practice location:
  • Phone: 901-538-7201
  • Fax: 901-538-7202
Mailing address:
  • Phone: 901-634-7516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number057594
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number10482
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: