Provider Demographics
NPI:1518214915
Name:RAHAIM, JAMES AUSTIN (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:AUSTIN
Last Name:RAHAIM
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 BROOKFIELD DR NW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8149
Mailing Address - Country:US
Mailing Address - Phone:901-299-1837
Mailing Address - Fax:
Practice Address - Street 1:101 REESE ST
Practice Address - Street 2:
Practice Address - City:BAY SAINT LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-2807
Practice Address - Country:US
Practice Address - Phone:901-299-1837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3663-121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics