Provider Demographics
NPI:1679791040
Name:TINNEMEYER, JAMES WILLIAM SR
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:TINNEMEYER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:WILLIAM
Other - Last Name:TINNEMEYER
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:1079 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3122
Mailing Address - Country:US
Mailing Address - Phone:412-344-7811
Mailing Address - Fax:412-344-5520
Practice Address - Street 1:1079 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3122
Practice Address - Country:US
Practice Address - Phone:412-344-7811
Practice Address - Fax:412-344-5520
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0169871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics