Provider Demographics
NPI:1104160670
Name:JAMES HOMON, DDS, MS
Entity type:Organization
Organization Name:JAMES HOMON, DDS, MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, PC
Authorized Official - Phone:614-932-9356
Mailing Address - Street 1:10401 SAWMILL PKWY
Mailing Address - Street 2:SUITE 50
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7451
Mailing Address - Country:US
Mailing Address - Phone:614-932-9356
Mailing Address - Fax:614-932-9361
Practice Address - Street 1:10401 SAWMILL PKWY
Practice Address - Street 2:SUITE 50
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7451
Practice Address - Country:US
Practice Address - Phone:614-932-9356
Practice Address - Fax:614-932-9361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0208321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty