Provider Demographics
NPI:1932315967
Name:CECCHINI, JAMES J III (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:CECCHINI
Suffix:III
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 1:415 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3667
Mailing Address - Country:US
Mailing Address - Phone:323-722-5000
Mailing Address - Fax:323-728-0549
Practice Address - Street 1:415 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3667
Practice Address - Country:US
Practice Address - Phone:323-722-5000
Practice Address - Fax:323-728-0549
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA402111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice