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Deactivated NPI 1720084064 Deactivated / Inactive NPI Male Practitioner

Dr. James B Willis , DDS

Dentist - General Practice • Polson, MT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. James Willis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 22, 2005
NPI Deactivation Date June 28, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. James Willis, DDS was a registered Dentist - General Practice practicing in Polson, MT. Throughout an active medical career spanning 16 years, Dr. Willis provided care at the practice location at 102 1ST AVE E until profile deactivation on 2021-06-28.

Practice Location & Contact Primary Location

Practice Address

102 1st Ave E

Polson, MT 598602335

Telephone 4068835544
Fax 4068835420
Associated Practice Facility / Clinic
🏢 Big Sky Dental Clinic Facility NPI 1144623992

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Polson, MT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
11 Specialists

Practicing in Polson, MT (489 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MT 1408

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1073745386

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 28, 2021

Record deactivated on June 28, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 102 1ST AVE E, POLSON, MT 598602335 (Tel: 4068835544)

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Updated Business Mailing Address July 08, 2007

Registered at 102 1ST AVE E, POLSON, MT 598602335 (Tel: 4068835544)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JAMES WILLIS, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #1408 in MT)

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Initial NPI Registration & Enumeration June 22, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720084064
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 22, 2005
Last Update: July 08, 2007
Deactivation Date: June 28, 2021

Mailing Address

102 1st Ave E

Polson, MT 598602335

Phone: 4068835544

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.