Provider Demographics
NPI:1508900648
Name:RINEHART, JOHN D (MAGD, DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:RINEHART
Suffix:
Gender:M
Credentials:MAGD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WESNER LANE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8023
Mailing Address - Country:US
Mailing Address - Phone:570-275-2684
Mailing Address - Fax:570-275-6617
Practice Address - Street 1:4 WESNER LANE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-8023
Practice Address - Country:US
Practice Address - Phone:570-275-2684
Practice Address - Fax:570-275-6617
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020679L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice