Provider Demographics
NPI:1508487562
Name:SWOPE, JONATHAN G (DDS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:G
Last Name:SWOPE
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 1:1204 THOMASVILLE CT
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044
Mailing Address - Country:US
Mailing Address - Phone:469-625-0507
Mailing Address - Fax:
Practice Address - Street 1:1204 THOMASVILLE CT
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044
Practice Address - Country:US
Practice Address - Phone:469-625-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366001223G0001X, 122300000X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty