Provider Demographics
NPI:1043338031
Name:CRYDER, JAMES R (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:CRYDER
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 1:11329 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4201
Mailing Address - Country:US
Mailing Address - Phone:513-772-1671
Mailing Address - Fax:513-771-1155
Practice Address - Street 1:11329 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4201
Practice Address - Country:US
Practice Address - Phone:513-772-1671
Practice Address - Fax:513-771-1155
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0174481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics