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General NPI Number Information
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NPI Number | 1467011023
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Entity Type | Individual
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Provider Name | JOSE GARCIA
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Gender | Male
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 4257 W 3RD ST
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City | DAYTON
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State | OH
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Zip | 45417-1406
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Country | US
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Telephone | 937-268-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 4829 4TH ST NW APT 4
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City | WASHINGTON
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State | DC
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Zip | 20011-6100
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Country | US
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Telephone | 301-313-1613
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN1002120
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 16994
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 62055
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30.027973
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License Number State | OH
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