Provider Demographics
NPI:1407040686
Name:HIGHT, JAMES RAY JR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAY
Last Name:HIGHT
Suffix:JR
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:HIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:101 MAX LANE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-5206
Mailing Address - Country:US
Mailing Address - Phone:731-427-1696
Mailing Address - Fax:
Practice Address - Street 1:101 MAX LANE DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-427-1696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS33361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3206683Medicaid