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General NPI Number Information
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NPI Number | 1225685183
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Entity Type | Individual
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Provider Name | JONATHAN MICHAEL WINFIELD DDS
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Gender | Male
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Dates
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Enumeration Date | 08/24/2019
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 6560 W FULLERTON AVE UNIT C106
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City | CHICAGO
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State | IL
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Zip | 60707-3439
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Country | US
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Telephone | 773-385-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 905 1/2 CREST RD
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City | DEL MAR
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State | CA
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Zip | 92014-2617
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Country | US
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Telephone | 858-213-4856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DDS108485
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | S5-60C
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.032358
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License Number State | IL
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