Provider Demographics
NPI:1356424154
Name:BAUM, JAMES NORRIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NORRIS
Last Name:BAUM
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 1:12709 MILL LOCK TER
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2861
Mailing Address - Country:US
Mailing Address - Phone:804-379-8862
Mailing Address - Fax:
Practice Address - Street 1:25 S NANSEMOND ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2746
Practice Address - Country:US
Practice Address - Phone:804-359-5041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA58561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice