Provider Demographics
NPI:1770640591
Name:JAMES, BEN JUSTUS III (DDS)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:JUSTUS
Last Name:JAMES
Suffix:III
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 1:100 N 12TH ST
Mailing Address - Street 2:502 CENTERSTONE
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1410
Mailing Address - Country:US
Mailing Address - Phone:402-476-8058
Mailing Address - Fax:
Practice Address - Street 1:100 N 12TH ST
Practice Address - Street 2:502 CENTERSTONE
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1410
Practice Address - Country:US
Practice Address - Phone:402-476-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE40971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice