MEDICARE: DR. JAMES A. RINEHIMER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DSO19713L	PA

General Provider Information

NPI Number	:	1629130364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES A. RINEHIMER D.D.S.

Provider Business Mailing Address
First Line	:	HC 87 BOX 109A ROUTE 940
Second Line	:	VILLAGE PARK CENTER
City	:	POCONO LAKE
State	:	PA
Zip	:	18347
Country	:	US
Telephone Number	:	570-646-9444
Fax Number	:	570-646-6878

Provider Business Practice Location Address
First Line	:	HC 87 BOX 109A ROUTE 940
Second Line	:	VILLAGE PARK CENTER
City	:	POCONO LAKE
State	:	PA
Zip	:	18347
Country	:	US
Telephone Number	:	570-646-9444
Fax Number	:	570-646-6878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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