Provider Demographics
NPI:1457738833
Name:TATE, JAMES CALVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CALVIN
Last Name:TATE
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 1:4618 AMAROSA HTS APT 304
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7872
Mailing Address - Country:US
Mailing Address - Phone:918-645-4009
Mailing Address - Fax:
Practice Address - Street 1:550 THORNTON PKWY UNIT 240B
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2172
Practice Address - Country:US
Practice Address - Phone:303-650-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1390200000X
CO00204911122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program