Provider Demographics
NPI:1659493815
Name:BIGBY, JOHN JASON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JASON
Last Name:BIGBY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7501 PARAGON RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-5318
Mailing Address - Country:US
Mailing Address - Phone:937-291-0022
Mailing Address - Fax:937-291-0190
Practice Address - Street 1:7501 PARAGON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-5318
Practice Address - Country:US
Practice Address - Phone:937-291-0022
Practice Address - Fax:937-291-0190
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-02-16681223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics