Provider Demographics
NPI:1508918418
Name:CRAIG, JAMES S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9515 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-3656
Mailing Address - Country:US
Mailing Address - Phone:913-397-9928
Mailing Address - Fax:913-888-0643
Practice Address - Street 1:12208 W 87TH STREET PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2812
Practice Address - Country:US
Practice Address - Phone:913-888-0403
Practice Address - Fax:913-888-0643
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS52561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice