Provider Demographics
NPI:1023677135
Name:PINER, JAMES E
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:PINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 S SEMORAN BLVD STE 5A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1777
Mailing Address - Country:US
Mailing Address - Phone:407-545-4451
Mailing Address - Fax:407-982-7278
Practice Address - Street 1:5425 S SEMORAN BLVD STE 5A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1777
Practice Address - Country:US
Practice Address - Phone:407-545-4451
Practice Address - Fax:407-982-7278
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN240491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice