Provider Demographics
NPI:1922052653
Name:HITCHCOCK, JAMES HUET (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HUET
Last Name:HITCHCOCK
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 1:14221 WEST RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA STATION
Mailing Address - State:OH
Mailing Address - Zip Code:44028-9436
Mailing Address - Country:US
Mailing Address - Phone:440-236-8640
Mailing Address - Fax:
Practice Address - Street 1:14221 WEST RIVER ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBIA STATION
Practice Address - State:OH
Practice Address - Zip Code:44028-9436
Practice Address - Country:US
Practice Address - Phone:440-236-8640
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice