Provider Demographics
NPI:1225249873
Name:KAUFFMAN, JOHN STEWART (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEWART
Last Name:KAUFFMAN
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 1:315 ELGIN CIR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6152
Mailing Address - Country:US
Mailing Address - Phone:717-766-9179
Mailing Address - Fax:717-795-8285
Practice Address - Street 1:222 S MARKET ST
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6315
Practice Address - Country:US
Practice Address - Phone:717-766-4525
Practice Address - Fax:717-795-8285
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS23785L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice