Provider Demographics
NPI:1578614186
Name:JAMES H MUCCI, DDS, INC.
Entity Type:Organization
Organization Name:JAMES H MUCCI, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:MUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-481-0594
Mailing Address - Street 1:4360 ARDEN WAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-3153
Mailing Address - Country:US
Mailing Address - Phone:916-481-0594
Mailing Address - Fax:916-481-2510
Practice Address - Street 1:4360 ARDEN WAY
Practice Address - Street 2:SUITE 5
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-3153
Practice Address - Country:US
Practice Address - Phone:916-481-0594
Practice Address - Fax:916-481-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty