Provider Demographics
NPI:1154449403
Name:ATHANS, JOHN NICHOLAS JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NICHOLAS
Last Name:ATHANS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8840 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1873
Mailing Address - Country:US
Mailing Address - Phone:716-688-0777
Mailing Address - Fax:716-688-7425
Practice Address - Street 1:8840 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1873
Practice Address - Country:US
Practice Address - Phone:716-688-0777
Practice Address - Fax:716-688-7425
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0423333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist