Healthcare Provider Details

I. General information

NPI: 1972792166
Provider Name (Legal Business Name): JON WILLIAM OHNEZEIT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011A FRIENDSHIP AVE
PITTSBURGH PA
15224-1701
US

IV. Provider business mailing address

5011A FRIENDSHIP AVE
PITTSBURGH PA
15224-1701
US

V. Phone/Fax

Practice location:
  • Phone: 412-589-2430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS037247
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: