Provider Demographics
NPI:1639200926
Name:DR. JAMES P. JULIAN, D.D.S., P.C.
Entity type:Organization
Organization Name:DR. JAMES P. JULIAN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:JULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:276-634-0071
Mailing Address - Street 1:PO BOX 3786
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24115-3786
Mailing Address - Country:US
Mailing Address - Phone:276-634-0071
Mailing Address - Fax:276-634-0074
Practice Address - Street 1:904 BROOKDALE STREET
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112
Practice Address - Country:US
Practice Address - Phone:276-634-0071
Practice Address - Fax:276-634-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010054881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401005488OtherSTATE LICENSE NUMBER
VA236209OtherANTHEM BCBS PROVIDER NO
AJ8792524OtherDEA NUMBER
VA236209OtherANTHEM BCBS PROVIDER NO