Provider Demographics
NPI:1114096526
Name:LEWIS, JOHN FRANCIS (MS DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MS DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 FIELDWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628
Mailing Address - Country:US
Mailing Address - Phone:916-987-6870
Mailing Address - Fax:
Practice Address - Street 1:1675 ALHAMBRA BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-455-3247
Practice Address - Fax:916-455-0439
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA334891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics