Provider Demographics
NPI:1629141973
Name:JAMES H NOTTINGHAM JR DMD
Entity Type:Organization
Organization Name:JAMES H NOTTINGHAM JR DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:NOTTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-623-9545
Mailing Address - Street 1:142 W YORK ST
Mailing Address - Street 2:SUITE 705
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2015
Mailing Address - Country:US
Mailing Address - Phone:757-623-9545
Mailing Address - Fax:757-623-4561
Practice Address - Street 1:142 W YORK ST
Practice Address - Street 2:SUITE 705
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2015
Practice Address - Country:US
Practice Address - Phone:757-623-9545
Practice Address - Fax:757-623-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006496122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA545349OtherUNITED CONCORDIA
VA088004OtherANTHEM