Provider Demographics
NPI:1376884601
Name:GIARDINA, JAMES PHILLIP (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PHILLIP
Last Name:GIARDINA
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 1:5013 ARLINGTON AVE
Mailing Address - Street 2:A
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2794
Mailing Address - Country:US
Mailing Address - Phone:951-785-5054
Mailing Address - Fax:
Practice Address - Street 1:5013 ARLINGTON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504
Practice Address - Country:US
Practice Address - Phone:951-785-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist