Provider Demographics
NPI:1356621452
Name:JAMES J. LYNN, DMD, PA
Entity type:Organization
Organization Name:JAMES J. LYNN, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSANS
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:864-269-0600
Mailing Address - Street 1:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29641-1054
Mailing Address - Country:US
Mailing Address - Phone:864-269-0600
Mailing Address - Fax:
Practice Address - Street 1:105 SHERINGHAM DR
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-2615
Practice Address - Country:US
Practice Address - Phone:864-269-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1184641789OtherNEED NEW NPI # TYPE 2- TYPE 1 IS PRINTED BELOW