Provider Demographics
NPI:1194070912
Name:SUGG, JAMES ANDREW (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:SUGG
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 1:17810 HALF MOON LN
Mailing Address - Street 2:APT H
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4606
Mailing Address - Country:US
Mailing Address - Phone:910-995-3909
Mailing Address - Fax:
Practice Address - Street 1:518 4TH ST SW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2823
Practice Address - Country:US
Practice Address - Phone:910-995-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93581223G0001X
FL20975122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist