Provider Demographics
NPI:1316033467
Name:WINDELL, JAMES D (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:WINDELL
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 1:135 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-2348
Mailing Address - Country:US
Mailing Address - Phone:541-265-2261
Mailing Address - Fax:
Practice Address - Street 1:135 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-2348
Practice Address - Country:US
Practice Address - Phone:541-265-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5137122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist