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NPI 1164409157

NPI 1164409157 : JAMES MICHAEL HILL DDS, MS, MAGD, ABGD : PORTSMOUTH, VA

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General NPI Number Information
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    NPI Number           |    1164409157
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES MICHAEL HILL DDS, MS, MAGD, ABGD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/29/2005
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    Last Update Date     |    07/22/2021
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Provider Practice Location Address
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    Address Line         |    NAVAL MEDICAL CENTER PORTSMOUTH 620 JOHN PAUL JONES CIRCLE
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    City                 |    PORTSMOUTH
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    State                |    VA
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    Zip                  |    23708
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    Country              |    US
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    Telephone            |    757-836-1520
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    105 WEST ROAD 
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    City                 |    PORTSMOUTH
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    State                |    VA
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    Zip                  |    23707-1222
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    Country              |    US
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    Telephone            |    757-450-2682
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    4623
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    License Number State |    LA
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Taxonomy #2
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    4623
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    License Number State |    LA
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