Provider Demographics
NPI:1194044396
Name:MEILINGER, JOHN IGNATIUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:IGNATIUS
Last Name:MEILINGER
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 1:115 BANK STREET
Mailing Address - Street 2:JOHN I. MEILING DDS INC
Mailing Address - City:LODI
Mailing Address - State:OH
Mailing Address - Zip Code:44254
Mailing Address - Country:US
Mailing Address - Phone:330-948-1243
Mailing Address - Fax:330-948-4706
Practice Address - Street 1:115 BANK STREET
Practice Address - Street 2:JOHN I. MEILING DDS INC
Practice Address - City:LODI
Practice Address - State:OH
Practice Address - Zip Code:44254
Practice Address - Country:US
Practice Address - Phone:330-948-1243
Practice Address - Fax:330-948-4706
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0288086Medicaid