Provider Demographics
NPI:1326026469
Name:CARREIRO, JAMES S (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:CARREIRO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11450 OAKHURST RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3924
Mailing Address - Country:US
Mailing Address - Phone:727-595-4289
Mailing Address - Fax:727-517-1015
Practice Address - Street 1:11450 OAKHURST RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3924
Practice Address - Country:US
Practice Address - Phone:727-595-4289
Practice Address - Fax:727-517-1015
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00126611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL63885OtherBLUE CROSS/SHIELD
FL697827OtherUNITED CONCORDIA
FL188510OtherCOMPBENEFITS