Provider Demographics
NPI:1952386658
Name:NEWCOMB, JOHNATHAN CHRISTOPHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:CHRISTOPHER
Last Name:NEWCOMB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7375 W 52ND AVE
Mailing Address - Street 2:SUITE #330
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3748
Mailing Address - Country:US
Mailing Address - Phone:719-332-0378
Mailing Address - Fax:
Practice Address - Street 1:7375 W 52ND AVE
Practice Address - Street 2:SUITE #330
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3748
Practice Address - Country:US
Practice Address - Phone:719-332-0378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO91941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics