Provider Demographics
NPI:1093866584
Name:GEYDA, JAMES P (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:GEYDA
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 1:63 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-2315
Mailing Address - Country:US
Mailing Address - Phone:203-467-7418
Mailing Address - Fax:203-466-1749
Practice Address - Street 1:63 HIGH ST
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-2315
Practice Address - Country:US
Practice Address - Phone:203-467-7418
Practice Address - Fax:203-466-1749
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist