Healthcare Provider Details

I. General information

NPI: 1245429810
Provider Name (Legal Business Name): JOHN FRANCIS LHOTA D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W 68TH ST SUITE 1A
NEW YORK NY
10023-5302
US

IV. Provider business mailing address

25 W 68TH ST SUITE 1A
NEW YORK NY
10023-5302
US

V. Phone/Fax

Practice location:
  • Phone: 212-579-8885
  • Fax: 212-579-8881
Mailing address:
  • Phone: 212-579-8885
  • Fax: 212-579-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0403881
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: