Provider Demographics
NPI:1215001250
Name:JUDAY, JAMES BRADLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRADLEY
Last Name:JUDAY
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 1:7815 E JEFFERSON AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3704
Mailing Address - Country:US
Mailing Address - Phone:313-499-4775
Mailing Address - Fax:313-499-4908
Practice Address - Street 1:7815 E JEFFERSON AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3704
Practice Address - Country:US
Practice Address - Phone:313-499-4775
Practice Address - Fax:313-499-4908
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist