Provider Demographics
NPI:1083050066
Name:HADDEN, JAMES D (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:HADDEN
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 1:225 E 2ND ST
Mailing Address - Street 2:APARTMENT #3
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2366
Mailing Address - Country:US
Mailing Address - Phone:308-432-8124
Mailing Address - Fax:
Practice Address - Street 1:225 E 2ND ST
Practice Address - Street 2:APT #3
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2366
Practice Address - Country:US
Practice Address - Phone:308-432-8124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7086122300000X, 1223D0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE7086Medicaid