Provider Demographics
NPI:1437345717
Name:EVERETT, JAMES ATKINSON (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ATKINSON
Last Name:EVERETT
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 1:18100 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-6252
Mailing Address - Country:US
Mailing Address - Phone:313-884-6680
Mailing Address - Fax:
Practice Address - Street 1:18100 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-6252
Practice Address - Country:US
Practice Address - Phone:313-884-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI134451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice