Provider Demographics
NPI:1780187989
Name:LEMON, JAMES DAVIS
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVIS
Last Name:LEMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 BRUSHY CREEK RD STE A
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-0903
Mailing Address - Country:US
Mailing Address - Phone:803-351-9225
Mailing Address - Fax:
Practice Address - Street 1:3115 BRUSHY CREEK RD STE A
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0903
Practice Address - Country:US
Practice Address - Phone:803-351-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice