Jonathan Louick, DMD
Individual provider Active NPI General Practice Dentistry · Chaddsford, PA
NPI 1346311396 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1346311396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS035692 (PA)
- Practice address
- 8 Pond'S Edge Drive
Suite#2
Chaddsford, PA 19317 - Phone
- (610) 388-4466
- Fax
- (610) 388-5808
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035692 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Family Dentisitry P.C. | General Practice | Past | Accepting new patients |
| A Plus Oral Surgery Specialty Care, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS035692 | PA | Yes |
Addresses
Primary practice location
8 Pond'S Edge Drive
Suite#2
Chaddsford, PA 19317
Mailing address
8 Pond'S Edge Drive
Suite#2
Chaddsford, PA 19317
Phone (610) 388-4466
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101397399 | Medicaid | PA |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.