Walter Robert James, D.D.S.
Individual provider Active NPI Dentist · Braidwood, IL
NPI 1992864987 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992864987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 133 S Lincoln St
Braidwood, IL 60408-1945 - Phone
- (815) 458-2221
- Fax
- (815) 458-3266
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
133 S Lincoln St
Braidwood, IL 60408-1945
Mailing address
133 S Lincoln St
Braidwood, IL 60408-1945
Phone (815) 458-2221
Other providers in Braidwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.