Provider Demographics
NPI:1447239611
Name:THOMAN, JOSEPH LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LYNN
Last Name:THOMAN
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 1:1611 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-3435
Mailing Address - Country:US
Mailing Address - Phone:319-277-8647
Mailing Address - Fax:
Practice Address - Street 1:1506 MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-4147
Practice Address - Country:US
Practice Address - Phone:319-266-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA067401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA25766OtherDELTA DENTAL
IA0047472Medicaid
IA11449283OtherFIRST HEALTH