Provider Demographics
NPI:1972919629
Name:DR. JAMES B BARNUM, DMD LLC
Entity type:Organization
Organization Name:DR. JAMES B BARNUM, DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-654-2101
Mailing Address - Street 1:2025 SE WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7612
Mailing Address - Country:US
Mailing Address - Phone:503-654-2101
Mailing Address - Fax:503-305-8384
Practice Address - Street 1:2025 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7612
Practice Address - Country:US
Practice Address - Phone:503-654-2101
Practice Address - Fax:503-305-8384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9245305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization