Provider Demographics
NPI:1528285483
Name:HILL, JAMES D (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:HILL
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:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-0187
Mailing Address - Country:US
Mailing Address - Phone:606-723-3555
Mailing Address - Fax:606-723-5816
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-1084
Practice Address - Country:US
Practice Address - Phone:606-723-3555
Practice Address - Fax:606-723-5816
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY047101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice