Provider Demographics
NPI:1316001654
Name:FLEMING, JAMES ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:FLEMING
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 1:2004 FOX DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-7336
Mailing Address - Country:US
Mailing Address - Phone:217-359-5087
Mailing Address - Fax:217-363-0295
Practice Address - Street 1:2004 FOX DR
Practice Address - Street 2:SUITE F
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7336
Practice Address - Country:US
Practice Address - Phone:217-359-5087
Practice Address - Fax:217-363-0295
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist