Provider Demographics
NPI:1982740981
Name:PINKERTON, JAMES DOUGLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:PINKERTON
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:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:SPEARMAN
Mailing Address - State:TX
Mailing Address - Zip Code:79081-0308
Mailing Address - Country:US
Mailing Address - Phone:806-659-3315
Mailing Address - Fax:806-659-9875
Practice Address - Street 1:206 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPEARMAN
Practice Address - State:TX
Practice Address - Zip Code:79081-2066
Practice Address - Country:US
Practice Address - Phone:806-659-3315
Practice Address - Fax:806-659-9875
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX197641223G0001X
KS602461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS116798OtherBCBS OF KANSAS
TXB19764-01OtherCHIPS PROVIDER NUMBER