Provider Demographics
NPI:1629004437
Name:ANGELOS, JAMES N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:N
Last Name:ANGELOS
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 1:1137 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2505
Mailing Address - Country:US
Mailing Address - Phone:626-584-3031
Mailing Address - Fax:626-584-3035
Practice Address - Street 1:1137 E GREEN ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2505
Practice Address - Country:US
Practice Address - Phone:626-584-3031
Practice Address - Fax:626-584-3035
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice