Provider Demographics
NPI:1669629648
Name:JAMES B. SCHWEICKART
Entity Type:Organization
Organization Name:JAMES B. SCHWEICKART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:SCHWEICKART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-532-6003
Mailing Address - Street 1:401 CENTER ST STE A
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1533
Mailing Address - Country:US
Mailing Address - Phone:740-532-6003
Mailing Address - Fax:740-532-1157
Practice Address - Street 1:401 CENTER ST STE A
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1533
Practice Address - Country:US
Practice Address - Phone:740-532-6003
Practice Address - Fax:740-532-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH197491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2344449Medicaid