Provider Demographics
NPI:1386869238
Name:KLOSS, JAMES LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LOUIS
Last Name:KLOSS
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 1:16652 WANDERER LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2146
Mailing Address - Country:US
Mailing Address - Phone:714-846-3042
Mailing Address - Fax:714-846-0225
Practice Address - Street 1:16652 WANDERER LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-2146
Practice Address - Country:US
Practice Address - Phone:714-846-3042
Practice Address - Fax:714-846-0225
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA203881223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics