Provider Demographics
NPI:1518510007
Name:JAMES, BONFACE N (DMD)
Entity Type:Individual
Prefix:
First Name:BONFACE
Middle Name:N
Last Name:JAMES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7207 E 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3916
Mailing Address - Country:US
Mailing Address - Phone:316-683-0440
Mailing Address - Fax:316-689-0300
Practice Address - Street 1:7207 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3916
Practice Address - Country:US
Practice Address - Phone:316-683-0440
Practice Address - Fax:316-689-0300
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS616741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice