Provider Demographics
NPI:1174579312
Name:WALDMAN, JAMES R (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:WALDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 N ELMHURST RD
Mailing Address - Street 2:SUITE #300
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1135
Mailing Address - Country:US
Mailing Address - Phone:847-259-3676
Mailing Address - Fax:847-259-7819
Practice Address - Street 1:999 N ELMHURST RD
Practice Address - Street 2:SUITE #300
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1135
Practice Address - Country:US
Practice Address - Phone:847-259-3676
Practice Address - Fax:847-259-7819
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice