Provider Demographics
NPI:1134143365
Name:KIMBRELL, JAMES STEVEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEVEN
Last Name:KIMBRELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 HELEN KELLER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-2902
Mailing Address - Country:US
Mailing Address - Phone:205-633-1900
Mailing Address - Fax:205-633-1154
Practice Address - Street 1:621 HELEN KELLER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2902
Practice Address - Country:US
Practice Address - Phone:205-633-1900
Practice Address - Fax:205-633-1154
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice