Provider Demographics
NPI:1922184373
Name:FISHBEIN, JAMES S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:FISHBEIN
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 1:2456 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5624
Mailing Address - Country:US
Mailing Address - Phone:603-436-9908
Mailing Address - Fax:603-436-1354
Practice Address - Street 1:2456 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5624
Practice Address - Country:US
Practice Address - Phone:603-436-9908
Practice Address - Fax:603-436-1354
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH17891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
X04589FIOtherMA BLUECROSS/BLUE SHIELD
020335040NH01OtherANTHEM BLUE CROSS/BLUE SH
NH30007227Medicaid
059397OtherUNITED CONCORDIA