Provider Demographics
NPI:1407913452
Name:MEGAHAN, JAMES R (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MEGAHAN
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 1:2550 MUNSTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2322
Mailing Address - Country:US
Mailing Address - Phone:248-375-0967
Mailing Address - Fax:248-652-2305
Practice Address - Street 1:4450 COLLINS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-1620
Practice Address - Country:US
Practice Address - Phone:248-652-3663
Practice Address - Fax:248-652-2305
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI132241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice