NPIMap

Organization Active NPI

Jon R. Ewig, DDS, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Beavercreek, OH
National Provider Identifier
1982650560
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
19277 Issued in OH
Legal business name
JON R. EWIG, DDS, INC.
Practice address
3585 Wendleton LN
Beavercreek, OH 45432-2753
Phone
(937) 426-8083
Fax
(937) 426-2818
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jon Robert Ewig, D.D.S.NPI 1720094246
Title
President
Phone
(937) 426-8083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 19277 OH Primary

Addresses

Primary practice location

3585 Wendleton LN
Beavercreek, OH 45432-2753

Mailing address

3585 Wendleton LN
Beavercreek, OH 45432-2753
Phone (937) 426-8083

Other identifiers 2

IdentifierTypeStateIssuer
0854928MedicaidOH
19277OtherOHOHIO LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982650560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 WENDLETON LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322753",
            "telephone_number": "937-426-8083",
            "fax_number": "937-426-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 WENDLETON LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322753",
            "telephone_number": "937-426-8083",
            "fax_number": "937-426-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON R. EWIG, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EWIG",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-426-8083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "19277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0854928",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "19277",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.