Provider Demographics
NPI:1639774466
Name:ESTES, JAMES (RDH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ESTES
Suffix:
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5950 FISHHAWK CROSSING BLVD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-5878
Mailing Address - Country:US
Mailing Address - Phone:813-446-7450
Mailing Address - Fax:
Practice Address - Street 1:2119 W BRANDON BLVD STE F
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4731
Practice Address - Country:US
Practice Address - Phone:813-662-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist