Provider Demographics
NPI:1164552139
Name:BICHEFSKY, JORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JORDON
Middle Name:
Last Name:BICHEFSKY
Suffix:
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 1:456 HOGELAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3380
Mailing Address - Country:US
Mailing Address - Phone:215-355-4765
Mailing Address - Fax:
Practice Address - Street 1:12109 CENTENNIAL STA
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-5488
Practice Address - Country:US
Practice Address - Phone:215-443-0400
Practice Address - Fax:215-443-9187
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015037122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice