Provider Demographics
NPI:1659544781
Name:MENZIES, JAMES WESLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WESLEY
Last Name:MENZIES
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 1:16320 70TH PL W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-4901
Mailing Address - Country:US
Mailing Address - Phone:425-743-5649
Mailing Address - Fax:
Practice Address - Street 1:6044 MARTIN LUTHER KING JR WAY S
Practice Address - Street 2:SUITE101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3179
Practice Address - Country:US
Practice Address - Phone:206-760-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000032911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice