Provider Demographics
NPI:1457422941
Name:WRIGHT, JAMES EVANS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EVANS
Last Name:WRIGHT
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:PO BOX 418
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:VT
Mailing Address - Zip Code:05735-0418
Mailing Address - Country:US
Mailing Address - Phone:802-468-5626
Mailing Address - Fax:802-468-5628
Practice Address - Street 1:1939 ROUTE 4A
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:VT
Practice Address - Zip Code:05735
Practice Address - Country:US
Practice Address - Phone:802-468-5626
Practice Address - Fax:802-468-5628
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT5231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTWRIG9191756OtherBLUE CROSS BLUE SHIELD
VT0001756Medicaid