Provider Demographics
NPI:1619945243
Name:CORNICK, JAMES KILLINGER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KILLINGER
Last Name:CORNICK
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 1:763 CONFUSION ACRES DR
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-2306
Mailing Address - Country:US
Mailing Address - Phone:540-721-5250
Mailing Address - Fax:
Practice Address - Street 1:230 MARKET STREET
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:VA
Practice Address - Zip Code:24127
Practice Address - Country:US
Practice Address - Phone:540-864-5556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0414111291223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health