Provider Demographics
NPI:1831188838
Name:GIFT, JAMES J (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:GIFT
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 N DALE MABRY HWY
Mailing Address - Street 2:BLDG 801
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3290
Mailing Address - Country:US
Mailing Address - Phone:813-931-0700
Mailing Address - Fax:813-933-8009
Practice Address - Street 1:8001 N DALE MABRY HWY
Practice Address - Street 2:BLDG 801
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3290
Practice Address - Country:US
Practice Address - Phone:813-931-0700
Practice Address - Fax:813-933-8009
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00154111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075164200Medicaid
U84035Medicare UPIN
FL075164200Medicaid