Provider Demographics
NPI:1043659139
Name:SAOUD, JAMES JOSEPH (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:SAOUD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 E WILLIAMS BLVD APT 4305
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7464
Mailing Address - Country:US
Mailing Address - Phone:520-777-0616
Mailing Address - Fax:
Practice Address - Street 1:5577 N ORACLE RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3878
Practice Address - Country:US
Practice Address - Phone:520-777-0616
Practice Address - Fax:520-888-3037
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI02538700122300000X
AZD0088631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD008863OtherAZ DENTAL LICENSE