Provider Demographics
NPI:1700088283
Name:HIEB, JAMES CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:HIEB
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 1:309 SHEYENNE ST
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078
Mailing Address - Country:US
Mailing Address - Phone:701-282-5035
Mailing Address - Fax:701-433-0641
Practice Address - Street 1:309 SHEYENNE ST
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078
Practice Address - Country:US
Practice Address - Phone:701-282-5035
Practice Address - Fax:701-433-0641
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND17071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND40893Medicaid