Provider Demographics
NPI:1326421637
Name:JAMES E. DUMAS, DDS, PC
Entity Type:Organization
Organization Name:JAMES E. DUMAS, DDS, PC
Other - Org Name:SUMMIT ORAL & MAXILLOFACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:DUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:260-451-2000
Mailing Address - Street 1:10020 DUPONT CIRCLE CT.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1635
Mailing Address - Country:US
Mailing Address - Phone:260-451-2000
Mailing Address - Fax:260-451-2200
Practice Address - Street 1:10020 DUPONT CIRCLE CT.
Practice Address - Street 2:SUITE 150
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1635
Practice Address - Country:US
Practice Address - Phone:260-451-2000
Practice Address - Fax:260-451-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006094A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1700804085Medicaid
INT99340Medicare UPIN