James Bryan Quattlebaum, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28376 Issued in CA

Practice address

8260 Longleaf Drive
C1-115
Elk Grove, CA 95758

Phone

(916) 691-0259

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1649272774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 LONGLEAF DRIVE",
            "address_2": "C1-115",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95758",
            "telephone_number": "916-691-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 LONGLEAF DRIVE",
            "address_2": "C1-115",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95758",
            "telephone_number": "916-691-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATTLEBAUM",
        "first_name": "JAMES",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28376",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "28376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.