Provider Demographics
NPI:1891795233
Name:MAYER, JAMES E (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:MAYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4447 TALMADGE RD
Mailing Address - Street 2:STE A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3517
Mailing Address - Country:US
Mailing Address - Phone:419-479-3939
Mailing Address - Fax:419-479-3933
Practice Address - Street 1:4447 TALMADGE RD
Practice Address - Street 2:STE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3517
Practice Address - Country:US
Practice Address - Phone:419-479-3939
Practice Address - Fax:419-479-3933
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183921223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2403796Medicaid
OHMA4048001Medicare ID - Type UnspecifiedJAMES E. MAYER JR. D.D.S.
OH2403796Medicaid