Provider Demographics
NPI:1710138797
Name:PENCHAS, JONATHAN (DMD, PA)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:PENCHAS
Suffix:
Gender:M
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3129
Mailing Address - Country:US
Mailing Address - Phone:713-807-9877
Mailing Address - Fax:713-807-0501
Practice Address - Street 1:315 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3129
Practice Address - Country:US
Practice Address - Phone:713-807-9877
Practice Address - Fax:713-807-0501
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX184151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics