Provider Demographics
NPI:1043324817
Name:BIRNBAUM, JAMES CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CRAIG
Last Name:BIRNBAUM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 NW 33RD ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-346-0010
Mailing Address - Fax:954-346-1967
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:SUITE 217
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-346-0010
Practice Address - Fax:954-346-1967
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00119351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice