Provider Demographics
NPI:1942248786
Name:LEWIS, JOHN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:SUITE 1420
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-4800
Mailing Address - Country:US
Mailing Address - Phone:316-265-0849
Mailing Address - Fax:316-265-6307
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:SUITE 1420
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-4800
Practice Address - Country:US
Practice Address - Phone:316-265-0849
Practice Address - Fax:316-265-6307
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2022-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS64451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice