1003913658 NPI number — JAMES M. MEEKS, DDS., MS., INC.

Table of content: MELISSA MARIE EISENHAUER PA (NPI 1295391217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003913658 NPI number — JAMES M. MEEKS, DDS., MS., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES M. MEEKS, DDS., MS., INC.
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:
6
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:
1003913658
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 CORPORATE DR STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LADERA RANCH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92694-1154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-347-2525
Provider Business Mailing Address Fax Number:
949-347-2552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 CORPORATE DR
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
LADERA RANCH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92694-1152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-347-2525
Provider Business Practice Location Address Fax Number:
949-347-2552
Provider Enumeration Date:
09/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MEEKS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
MARTIN
Authorized Official Title or Position:
ORTHODONTIST
Authorized Official Telephone Number:
949-347-2525

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  33340 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 33340 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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