James George Trantham IV, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17570 Issued in FL

Practice address

1704 Airport Blvd Ste a
Melbourne, FL 32901

Phone

(321) 473-5414

Fax

(321) 952-1469

NPI assigned

Jul 27, 2006

Last updated

Jun 29, 2018By 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 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1265456826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 AIRPORT BLVD STE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014313",
            "telephone_number": "321-473-5414",
            "fax_number": "321-952-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 AIRPORT BLVD STE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-473-5414",
            "fax_number": "321-952-1469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4124 University Blvd South",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164317",
            "country_code": "US",
            "telephone_number": "904-733-3763",
            "fax_number": "904-733-9783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRANTHAM",
        "first_name": "JAMES",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17570",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17570",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Melbourne, FL
• Providers in Melbourne, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.