Provider Demographics
NPI:1922651801
Name:ICHIUJI, JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:ICHIUJI
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 1:9260 ALCOSTA BLVD STE D30
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4100
Mailing Address - Country:US
Mailing Address - Phone:925-876-5244
Mailing Address - Fax:
Practice Address - Street 1:9260 ALCOSTA BLVD STE D30
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4100
Practice Address - Country:US
Practice Address - Phone:925-828-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1040941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice