Conner Christian Diminick, DMD

Individual provider Active NPI General Practice Dentistry · Mount Joy, PA

NPI 1164049896 · NPPES record last updated Jun 29, 2020

Key facts

NPI
1164049896
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS042745 (PA)
Practice address
1013 W Main St Ste 6
Mount Joy, PA 17552-9699
Phone
(717) 653-8177
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS042745PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
JTH Dental Inc. General Practice Current
since Jun 12, 2022
Accepting new patients
Hugh Wenger DDS Associates General Practice Past
since Jul 5, 2020
Accepting new patients

Locations

1013 W Main St
Ste 6
Mount Joy, PA 17552
Phone (717) 653-8177

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS042745 PA Yes

Addresses

Primary practice location

1013 W Main St Ste 6
Mount Joy, PA 17552-9699

Mailing address

755 Summit Dr Apt 224
Lancaster, PA 17601-1163
Phone (717) 405-1590

Other providers in Mount Joy, PA

All providers in Mount Joy, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.