Provider Demographics
NPI:1184628786
Name:LIGNELLI, JOHN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:LIGNELLI
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 1:1630 E HIGH ST
Mailing Address - Street 2:BLDG 4
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3244
Mailing Address - Country:US
Mailing Address - Phone:610-326-7880
Mailing Address - Fax:610-326-5491
Practice Address - Street 1:1630 E HIGH ST
Practice Address - Street 2:BLDG 4
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3244
Practice Address - Country:US
Practice Address - Phone:610-326-7880
Practice Address - Fax:610-326-5491
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-018039L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4100943OtherAETNA COMMERCIAL PLANS
PALI160525OtherHIGHMARK
PA1183294-007OtherCIGNA
PA03208701OtherCAPITAL BLUE CROSS
PA0048330000OtherKEYSTONE HEALTH PLAN EAST
PA0017855OtherAETNA HMO
PA1183294-007OtherCIGNA
PA0048330000OtherKEYSTONE HEALTH PLAN EAST