Provider Demographics
NPI:1902077894
Name:STATHIS, JAMES G (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:STATHIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3905 STATE ST
Mailing Address - Street 2:264
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3138
Mailing Address - Country:US
Mailing Address - Phone:805-451-0118
Mailing Address - Fax:805-563-9741
Practice Address - Street 1:3905 STATE ST
Practice Address - Street 2:264
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3138
Practice Address - Country:US
Practice Address - Phone:805-451-0118
Practice Address - Fax:805-563-9741
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33668122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist