Provider Demographics
NPI:1922147883
Name:SMITH, JAMES CALVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CALVIN
Last Name:SMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:C
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:737 IRBY LANE
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061
Mailing Address - Country:US
Mailing Address - Phone:972-259-3614
Mailing Address - Fax:972-259-1920
Practice Address - Street 1:737 IRBY LANE
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061
Practice Address - Country:US
Practice Address - Phone:972-259-3614
Practice Address - Fax:972-259-1920
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist