Provider Demographics
NPI:1922361690
Name:ANNA JOSE WARNOCK DDS INC
Entity Type:Organization
Organization Name:ANNA JOSE WARNOCK DDS INC
Other - Org Name:WARNOCK DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:WARNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-891-2008
Mailing Address - Street 1:925 N STATE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082
Mailing Address - Country:US
Mailing Address - Phone:614-891-2008
Mailing Address - Fax:614-891-2006
Practice Address - Street 1:925 N STATE ST
Practice Address - Street 2:SUITE D
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082
Practice Address - Country:US
Practice Address - Phone:614-891-2008
Practice Address - Fax:614-891-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213951223G0001X
OH217631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty