John Whytosek D.M.D. P.C

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS030593L Issued in PA

Legal business name

JOHN WHYTOSEK D.M.D. P.C

Practice address

2004 Sproul Road
Suite 304
Broomall, PA 19008

Phone

(610) 353-8200

Fax

(610) 356-0900

NPI assigned

Sep 16, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mariann Smith

Title

Office Manager

Phone

(610) 353-8200

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1700119187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 SPROUL ROAD",
            "address_2": "SUITE 304",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "19008",
            "telephone_number": "610-353-8200",
            "fax_number": "610-356-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 SPROUL ROAD",
            "address_2": "SUITE 304",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "19008",
            "telephone_number": "610-353-8200",
            "fax_number": "610-356-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN WHYTOSEK D.M.D. P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARIANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-353-8200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS030593L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hans Jensen, DO
• Jillian Hatch, Lactation Consultant
• David Johnson, ED.D.
• Gilda Audrey Johnson, CPNP
• Jamaal Deon Johnson
• Shanel Johnson, BEHAVIOR TECHNICIAN
• Dana Jolley, M.S., CCC-SLP

• Periodontics in Broomall, PA
• Providers in Broomall, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.