1760471254 NPI number — MR. JAMES PERCY HOOD III DENTIST

Table of content: MR. JAMES PERCY HOOD III DENTIST (NPI 1760471254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760471254 NPI number — MR. JAMES PERCY HOOD III DENTIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOD
Provider First Name:
JAMES
Provider Middle Name:
PERCY
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
III
Provider Credential Text:
DENTIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760471254
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20267 ISLAND VIEW CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTOMAC FALLS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20165-5135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-870-7077
Provider Business Mailing Address Fax Number:
301-843-8030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
603 POST OFFICE RD
Provider Second Line Business Practice Location Address:
208
Provider Business Practice Location Address City Name:
WALDORF
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20602-1914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-705-7552
Provider Business Practice Location Address Fax Number:
301-843-8030
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  10857 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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