1942421847 NPI number — JAMES F SHELDON DDS LTD

Table of content: (NPI 1942421847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942421847 NPI number — JAMES F SHELDON DDS LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES F SHELDON DDS LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1942421847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10540 W CERMAK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTCHESTER
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60154-5250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-562-4525
Provider Business Mailing Address Fax Number:
708-562-5505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10540 W CERMAK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTCHESTER
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60154-5250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-562-4525
Provider Business Practice Location Address Fax Number:
708-562-5505
Provider Enumeration Date:
05/01/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHELDON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
708-562-4525

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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