Provider Demographics
NPI:1477796621
Name:GUYMON, JAMES CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:GUYMON
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 1:4835 E CACTUS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4192
Mailing Address - Country:US
Mailing Address - Phone:602-788-4873
Mailing Address - Fax:602-466-3701
Practice Address - Street 1:4835 E CACTUS RD STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4192
Practice Address - Country:US
Practice Address - Phone:602-788-4873
Practice Address - Fax:602-466-3701
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0081631223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ610024Medicaid