Individual provider Active NPI

James Farris Adjan, DDS

  • Pediatric Dentistry
  • Bastrop, TX
National Provider Identifier
1962527481
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
25351 Issued in TX
Practice address
696 Highway 71 W
Suite 4D
Bastrop, TX 78602-4009
Phone
(512) 321-5437
Fax
(888) 317-1936
NPI assigned
Mar 21, 2007
Last updated
Nov 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30022364 OH
Pediatric Dentistry 1223P0221X 25351 TX Primary

Addresses

Primary practice location

696 Highway 71 W
Suite 4D
Bastrop, TX 78602-4009

Mailing address

696 Highway 71 W
Suite 4D
Bastrop, TX 78602-4009
Phone (512) 321-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30022364OHMDGeneral Practice Dentistry
25351TXMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1962527481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 HIGHWAY 71 W",
            "address_2": "SUITE 4D",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024009",
            "telephone_number": "512-321-5437",
            "fax_number": "888-317-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 HIGHWAY 71 W",
            "address_2": "SUITE 4D",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024009",
            "telephone_number": "512-321-5437",
            "fax_number": "888-317-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADJAN",
        "first_name": "JAMES",
        "middle_name": "FARRIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022364",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "25351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.