Provider Demographics
NPI:1871670885
Name:DEHNRT, JOHN ANTON (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTON
Last Name:DEHNRT
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 1:3945 E FORT LOWELL RD
Mailing Address - Street 2:SUITE #209
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1036
Mailing Address - Country:US
Mailing Address - Phone:520-628-2818
Mailing Address - Fax:520-319-5513
Practice Address - Street 1:3945 E FORT LOWELL
Practice Address - Street 2:SUITE #209
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1037
Practice Address - Country:US
Practice Address - Phone:520-628-2818
Practice Address - Fax:520-319-5513
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5315OtherAZ DENTAL LIC