Provider Demographics
NPI:1548484405
Name:FORD, JAMES BRADLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRADLEY
Last Name:FORD
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 1:118 N. HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215
Mailing Address - Country:US
Mailing Address - Phone:614-228-1113
Mailing Address - Fax:614-228-2276
Practice Address - Street 1:51 N HIGH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3031
Practice Address - Country:US
Practice Address - Phone:614-228-1113
Practice Address - Fax:614-228-2276
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30018757122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30018757OtherSTATE DENTAL LICENSE