Provider Demographics
NPI:1902394141
Name:JONATHAN P. KRIZNER, DDS
Entity Type:Organization
Organization Name:JONATHAN P. KRIZNER, DDS
Other - Org Name:NORVELT DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KRIZNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-438-0241
Mailing Address - Street 1:600 CHERRY TREE LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8947
Mailing Address - Country:US
Mailing Address - Phone:724-438-0241
Mailing Address - Fax:724-439-0500
Practice Address - Street 1:3940 STATE ROUTE 981
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-3705
Practice Address - Country:US
Practice Address - Phone:724-423-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JONATHAN P. KRIZNER, DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025257L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty