Provider Demographics
NPI:1568486603
Name:BYAS, JAMES SPENCER JR (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SPENCER
Last Name:BYAS
Suffix:JR
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:645 AERICK ST
Mailing Address - Street 2:STE #4
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301
Mailing Address - Country:US
Mailing Address - Phone:310-674-2692
Mailing Address - Fax:310-674-2232
Practice Address - Street 1:645 AERICK ST
Practice Address - Street 2:STE #4
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301
Practice Address - Country:US
Practice Address - Phone:310-674-2692
Practice Address - Fax:310-674-2232
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA256791223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B2567901OtherMEDI-CAL