Provider Demographics
NPI:1568478576
Name:ALDER, JAMES C (DMD, FAGD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:ALDER
Suffix:
Gender:M
Credentials:DMD, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16170 SW DONIN CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6366
Mailing Address - Country:US
Mailing Address - Phone:503-629-8046
Mailing Address - Fax:503-601-0612
Practice Address - Street 1:1600 SW CEDAR HILLS BLVD
Practice Address - Street 2:#110
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5439
Practice Address - Country:US
Practice Address - Phone:503-641-5667
Practice Address - Fax:503-601-0612
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR59331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice