Provider Demographics
NPI:1679762777
Name:FLYNN, JAMES M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:FLYNN
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 1:12470 N RANCHO VISTOSO BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1878
Mailing Address - Country:US
Mailing Address - Phone:520-575-9449
Mailing Address - Fax:520-469-9922
Practice Address - Street 1:12470 N RANCHO VISTOSO BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1878
Practice Address - Country:US
Practice Address - Phone:520-575-9449
Practice Address - Fax:520-469-9922
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice