Provider Demographics
NPI:1235332313
Name:VANBIBER, JAMES TAYLOR JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TAYLOR
Last Name:VANBIBER
Suffix:JR
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 1:3313 S. SEMINOLE CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:54057-2770
Mailing Address - Country:US
Mailing Address - Phone:816-795-9910
Mailing Address - Fax:
Practice Address - Street 1:13665 E 42ND TER S
Practice Address - Street 2:SUITE G
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7343
Practice Address - Country:US
Practice Address - Phone:816-350-0350
Practice Address - Fax:816-350-0352
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice