Provider Demographics
NPI:1003945981
Name:KANDA, JAMES M (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:KANDA
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 1:3043 FOOTHILL BLVD
Mailing Address - Street 2:SUITE1
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2715
Mailing Address - Country:US
Mailing Address - Phone:818-249-5900
Mailing Address - Fax:818-249-2312
Practice Address - Street 1:3043 FOOTHILL BLVD
Practice Address - Street 2:SUITE1
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-2715
Practice Address - Country:US
Practice Address - Phone:818-249-5900
Practice Address - Fax:818-249-2312
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice