Provider Demographics
NPI:1710259254
Name:ROGERS, JAMES (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3575 S TOWN CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-3045
Mailing Address - Country:US
Mailing Address - Phone:702-966-0300
Mailing Address - Fax:702-932-5144
Practice Address - Street 1:3575 S TOWN CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3045
Practice Address - Country:US
Practice Address - Phone:702-966-0300
Practice Address - Fax:702-932-5144
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS4-221223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics