Provider Demographics
NPI:1992959811
Name:JAMES W. CHERBERG, D.D.S., M.S.D., P.S.
Entity type:Organization
Organization Name:JAMES W. CHERBERG, D.D.S., M.S.D., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:CHERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD, PS
Authorized Official - Phone:206-624-1851
Mailing Address - Street 1:509 OLIVE WAY
Mailing Address - Street 2:#1041
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1720
Mailing Address - Country:US
Mailing Address - Phone:206-624-1851
Mailing Address - Fax:206-624-2033
Practice Address - Street 1:509 OLIVE WAY
Practice Address - Street 2:#1041
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1720
Practice Address - Country:US
Practice Address - Phone:206-624-1851
Practice Address - Fax:206-624-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA40601223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty