Provider Demographics
NPI:1891718573
Name:LOVELL, JONATHAN GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:GEORGE
Last Name:LOVELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 E. OLIVE AVE.
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-633-9955
Mailing Address - Fax:
Practice Address - Street 1:5331 S SUPERSTITION MOUNTAIN DR
Practice Address - Street 2:SUITE 108
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85218-1921
Practice Address - Country:US
Practice Address - Phone:480-671-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice