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NPI Code Detail

MEDICARE: SONJA ANN JARMOSZUK D.D.S.

MEDICARE: SONJA ANN JARMOSZUK D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry30021540OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336113570
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONJA ANN JARMOSZUK D.D.S.
Provider Business Mailing Address
First Line : 21261 MAPLEWOOD AVE
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-1243
Country : US
Telephone Number : 440-333-8053
Fax Number :
Provider Business Practice Location Address
First Line : 1800 LIVINGSTON AVE
Second Line :
City : LORAIN
State : OH
Zip : 44052-3781
Country : US
Telephone Number : 440-233-0100
Fax Number : 440-233-0109
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/08/2007

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