Provider Demographics
NPI:1942637574
Name:JON K. ORMSON, DDS, PLLC
Entity Type:Organization
Organization Name:JON K. ORMSON, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-882-2568
Mailing Address - Street 1:7628 CATSKILL AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1919
Mailing Address - Country:US
Mailing Address - Phone:713-882-2568
Mailing Address - Fax:
Practice Address - Street 1:4600 W I 40 STE 201
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-5836
Practice Address - Country:US
Practice Address - Phone:806-354-8526
Practice Address - Fax:806-353-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty