Provider Demographics
NPI:1306283544
Name:BEDDES, JAMES COLT (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:COLT
Last Name:BEDDES
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 1:4500 STARR ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-2338
Mailing Address - Country:US
Mailing Address - Phone:307-277-6272
Mailing Address - Fax:
Practice Address - Street 1:6040 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6640
Practice Address - Country:US
Practice Address - Phone:307-277-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE70811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice