Provider Demographics
NPI:1487815957
Name:OTTEN, JAMES F (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:OTTEN
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 1:930 IOWA ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1835
Mailing Address - Country:US
Mailing Address - Phone:785-843-6404
Mailing Address - Fax:785-865-5617
Practice Address - Street 1:930 IOWA ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1835
Practice Address - Country:US
Practice Address - Phone:785-843-6404
Practice Address - Fax:785-865-5617
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice