Provider Demographics
NPI:1255461992
Name:SIEBERTH, JAMES F (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:SIEBERTH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 GOODWOOD BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7736
Mailing Address - Country:US
Mailing Address - Phone:225-927-4717
Mailing Address - Fax:225-927-4756
Practice Address - Street 1:8170 GOODWOOD BLVD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7736
Practice Address - Country:US
Practice Address - Phone:225-927-4717
Practice Address - Fax:225-927-4756
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics