Provider Demographics
NPI:1609017102
Name:NIELSEN, JAMES SHELDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SHELDON
Last Name:NIELSEN
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 1:1286 WEST VAN ALSTYNE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-8055
Mailing Address - Country:US
Mailing Address - Phone:903-712-4440
Mailing Address - Fax:903-712-4441
Practice Address - Street 1:1286 WEST VAN ALSTYNE PARKWAY
Practice Address - Street 2:
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495-8055
Practice Address - Country:US
Practice Address - Phone:903-712-4440
Practice Address - Fax:903-712-4441
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist