Provider Demographics
NPI:1992859086
Name:VAN VOLKINBURG, JAMES WARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WARD
Last Name:VAN VOLKINBURG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5479 N FRESNO ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8328
Mailing Address - Country:US
Mailing Address - Phone:559-439-5280
Mailing Address - Fax:559-439-9126
Practice Address - Street 1:5479 N FRESNO ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8328
Practice Address - Country:US
Practice Address - Phone:559-439-5280
Practice Address - Fax:559-439-9126
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232511223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics