Provider Demographics
NPI:1790764355
Name:TAYLOR, JAMES ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1622 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6767
Mailing Address - Country:US
Mailing Address - Phone:757-539-2998
Mailing Address - Fax:757-539-0969
Practice Address - Street 1:1622 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6767
Practice Address - Country:US
Practice Address - Phone:757-539-2998
Practice Address - Fax:757-539-0969
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA7381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist