Provider Demographics
NPI:1710012422
Name:MCALLISTER, JAMES WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:MCALLISTER
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 1:4801 SOUTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4747
Mailing Address - Country:US
Mailing Address - Phone:712-274-7377
Mailing Address - Fax:712-274-8921
Practice Address - Street 1:4801 SOUTHERN HILLS DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4747
Practice Address - Country:US
Practice Address - Phone:712-274-7377
Practice Address - Fax:712-274-8921
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA67811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA986544OtherUNITED CONCORDIA
IA1199158Medicaid
IA19915OtherBLUECROSS BLUESHIELD