Provider Demographics
NPI:1326162918
Name:SANDS, JAMES DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:SANDS
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 1:5651 SW 64TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7109
Mailing Address - Country:US
Mailing Address - Phone:954-587-9737
Mailing Address - Fax:954-587-9738
Practice Address - Street 1:5651 SW 64TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7109
Practice Address - Country:US
Practice Address - Phone:954-587-9737
Practice Address - Fax:954-587-9738
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00079561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice