Provider Demographics
NPI:1710012802
Name:GIDDINGS, JOHN PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:GIDDINGS
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 1:935 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NE
Mailing Address - Zip Code:68446-9612
Mailing Address - Country:US
Mailing Address - Phone:402-269-3160
Mailing Address - Fax:402-269-3274
Practice Address - Street 1:935 1ST ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NE
Practice Address - Zip Code:68446-9612
Practice Address - Country:US
Practice Address - Phone:402-269-3160
Practice Address - Fax:402-269-3274
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist