Provider Demographics
NPI:1649426396
Name:MORGAN, JAMES A (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:MORGAN
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 1:1375 E 800 N
Mailing Address - Street 2:#105
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4435
Mailing Address - Country:US
Mailing Address - Phone:801-374-8744
Mailing Address - Fax:801-374-9860
Practice Address - Street 1:1375 E 800 N
Practice Address - Street 2:#105
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-4435
Practice Address - Country:US
Practice Address - Phone:801-374-8744
Practice Address - Fax:801-374-9860
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1441331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT688514OtherUNITED CONCORDIA
UT$$$$$$$$$006Medicaid