Pat Wimonsri, DMD
Individual provider Active NPI General Practice Dentistry · Gloucester City, NJ
NPI 1508540915 · NPPES record last updated Jun 14, 2023
Key facts
- NPI
- 1508540915
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22DI02977300 (NJ)
- Practice address
- 535 Monmouth St
Gloucester City, NJ 08030-1502 - Phone
- (856) 386-1174
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 22DI02977300 | NJ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02977300 | NJ | Yes |
Addresses
Primary practice location
535 Monmouth St
Gloucester City, NJ 08030-1502
Mailing address
1232 Chestnut St PH 1
Philadelphia, PA 19107-4822
Phone (347) 207-9814
Other practice location 1
1233 Haddonfield Berlin Rd Ste 6
Voorhees, NJ 08043-4378
Phone (856) 746-4570
Other providers in Gloucester City, NJ
- Nicola Rene Visaggio
- Vital Focus Therapy, LLC
- Larry Charles Wallis
- Heather Leigh Waring
- Well Path, LLC.
- Jessica Marie Zielinski
All providers in Gloucester City, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2023. 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.