Provider Demographics
NPI:1982087508
Name:SHOFF, JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:SHOFF
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 1:5435 BACKGLEN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-8600
Mailing Address - Country:US
Mailing Address - Phone:801-615-3593
Mailing Address - Fax:
Practice Address - Street 1:624 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-2136
Practice Address - Country:US
Practice Address - Phone:719-695-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7552921-99221223G0001X
CO002028971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice