Provider Demographics
NPI:1932261138
Name:JAMES, EAN (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:EAN
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 W COUNTY LINE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2301
Mailing Address - Country:US
Mailing Address - Phone:732-942-6900
Mailing Address - Fax:
Practice Address - Street 1:639 MOUNT PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-3109
Practice Address - Country:US
Practice Address - Phone:973-481-3900
Practice Address - Fax:973-481-2999
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI022765001223S0112X
PADS035766204E00000X
PAMD431861204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery