Provider Demographics
NPI:1477695344
Name:JAMES, JAY LANCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:LANCE
Last Name:JAMES
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 1:1415 ROZA VISTA PL
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1234
Mailing Address - Country:US
Mailing Address - Phone:509-882-3151
Mailing Address - Fax:509-882-2603
Practice Address - Street 1:201 EUCLID ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-1160
Practice Address - Country:US
Practice Address - Phone:509-882-3151
Practice Address - Fax:509-882-2603
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA77811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice