Provider Demographics
NPI:1174692669
Name:FODOR, JAMES NELSON (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NELSON
Last Name:FODOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 PINYON PINE ROAD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127
Mailing Address - Country:US
Mailing Address - Phone:303-903-5462
Mailing Address - Fax:303-340-3339
Practice Address - Street 1:601 SALIDA WAY
Practice Address - Street 2:B11 DENTRUST DENTAL
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011
Practice Address - Country:US
Practice Address - Phone:303-340-3330
Practice Address - Fax:303-340-3339
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO66951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice