Provider Demographics
NPI:1558456343
Name:HIGGINS, JAMES R (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1010 E 86TH ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1801
Mailing Address - Country:US
Mailing Address - Phone:317-844-3396
Mailing Address - Fax:317-844-4776
Practice Address - Street 1:1010 E 86TH ST
Practice Address - Street 2:SUITE 15
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1801
Practice Address - Country:US
Practice Address - Phone:317-844-3396
Practice Address - Fax:317-844-4776
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN12008992A1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics