Provider Demographics
NPI:1841378817
Name:NEUMEISTER, JAMES R (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:NEUMEISTER
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 1:406 WALL ST
Mailing Address - Street 2:
Mailing Address - City:EAST DUBUQUE
Mailing Address - State:IL
Mailing Address - Zip Code:61025-1432
Mailing Address - Country:US
Mailing Address - Phone:815-747-2263
Mailing Address - Fax:815-747-2265
Practice Address - Street 1:406 WALL ST
Practice Address - Street 2:
Practice Address - City:EAST DUBUQUE
Practice Address - State:IL
Practice Address - Zip Code:61025-1432
Practice Address - Country:US
Practice Address - Phone:815-747-2263
Practice Address - Fax:815-747-2265
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0934851Medicaid