James McClellan Deckman, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9630 Issued in GA

Practice address

125A Commerce Dr
Tyrone, GA 30290-2034

Phone

(770) 487-8787

Fax

(770) 486-1565

NPI assigned

Jul 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255354494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125A COMMERCE DR",
            "address_2": "PO BOX 219",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902034",
            "telephone_number": "770-487-8787",
            "fax_number": "770-486-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125A COMMERCE DR",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902034",
            "telephone_number": "770-487-8787",
            "fax_number": "770-486-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKMAN",
        "first_name": "JAMES",
        "middle_name": "MCCLELLAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tyrone, GA
• Providers in Tyrone, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.