Provider Demographics
NPI:1447093729
Name:O'BRIEN, JAMES SKYLAR (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SKYLAR
Last Name:O'BRIEN
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 1:1716 ONTARIO AVE APT 108
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9256
Mailing Address - Country:US
Mailing Address - Phone:318-880-4111
Mailing Address - Fax:
Practice Address - Street 1:2442 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2050
Practice Address - Country:US
Practice Address - Phone:815-748-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.035095122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist