Provider Demographics
NPI:1972558906
Name:JONATHAN PENCHAS D.M.D.,M.ED., PA.
Entity Type:Organization
Organization Name:JONATHAN PENCHAS D.M.D.,M.ED., PA.
Other - Org Name:MIDTOWN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENCHAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MED, PA
Authorized Official - Phone:713-807-9877
Mailing Address - Street 1:315 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3129
Mailing Address - Country:US
Mailing Address - Phone:713-807-9877
Mailing Address - Fax:713-807-0501
Practice Address - Street 1:315 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3129
Practice Address - Country:US
Practice Address - Phone:713-807-9877
Practice Address - Fax:713-807-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX184151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty