Provider Demographics
NPI:1578811089
Name:JAMES, JASON (DDS)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2838 N. OLIVER STREET
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220
Mailing Address - Country:US
Mailing Address - Phone:202-423-3897
Mailing Address - Fax:
Practice Address - Street 1:2838 N. OLIVER STREET
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220
Practice Address - Country:US
Practice Address - Phone:202-423-3897
Practice Address - Fax:316-978-8399
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program