Provider Demographics
NPI:1932181195
Name:HERNDON, JAMES NOEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NOEL
Last Name:HERNDON
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 1:425 W TRUMAN PL
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-3209
Mailing Address - Country:US
Mailing Address - Phone:405-527-7070
Mailing Address - Fax:405-527-3046
Practice Address - Street 1:425 W TRUMAN PL
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-3209
Practice Address - Country:US
Practice Address - Phone:405-527-7070
Practice Address - Fax:405-527-3046
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK47221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice