Jonathan Michael Drew, DDS, MS
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Lakeport, CA
NPI 1447733407 · NPPES record last updated Nov 19, 2022
Key facts
- NPI
- 1447733407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 102563 (CA)
- Practice address
- 120 9TH St
Lakeport, CA 95453-4320 - Phone
- (707) 263-5390
- NPI assigned
- Sep 14, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102563 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonathan M Drew DDS Inc | Orthodontics and Dentofacial Orthopedics | Current |
Accepting new patients |
Locations
120 9th St
Lakeport, CA 95453
Phone (707) 263-5390
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 102563 | CA | Yes |
Addresses
Primary practice location
120 9TH St
Lakeport, CA 95453-4320
Mailing address
3240 Finch Dr
San Jose, CA 95117-3512
Phone (408) 314-9870
Other providers in Lakeport, CA
- Joan Devito
- Richard Allan Diwald
- Tracey Michelle Dobusch
- Elyse Midori Donald
- Keith Phillip Donald
- Kathleen E Duchene
- Marlin Noelia Duran
- Gail P Dyne
- Easter Seals Bay Area
- Alyssa Eberhardt
All providers in Lakeport, CA · Orthodontics and Dentofacial Orthopedics Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2022. 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.