Provider Demographics
NPI:1902937162
Name:JULIAN, JAMES PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:JULIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3786
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24115-3786
Mailing Address - Country:US
Mailing Address - Phone:276-634-0071
Mailing Address - Fax:276-634-0074
Practice Address - Street 1:904 BROOKDALE STREET
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112
Practice Address - Country:US
Practice Address - Phone:276-634-0071
Practice Address - Fax:276-634-0074
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010054881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401005488OtherSTATE LICENSE NO
VA236209OtherANTHEM BCBS PROVIDER NO
AJ8792524OtherDEA NUMBER