Provider Demographics
NPI:1437234200
Name:DR JAMES V FROHNMAYER DMD PC
Entity Type:Organization
Organization Name:DR JAMES V FROHNMAYER DMD PC
Other - Org Name:PORTSMOUTH DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:VAUGHN
Authorized Official - Last Name:FROHNMAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-735-2182
Mailing Address - Street 1:5228 N LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203
Mailing Address - Country:US
Mailing Address - Phone:503-289-7043
Mailing Address - Fax:503-289-1425
Practice Address - Street 1:5228 N LOMBARD ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203
Practice Address - Country:US
Practice Address - Phone:503-289-7043
Practice Address - Fax:503-289-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD42181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty