MEDICARE: JOSHUA M. IGNATOWICZ DMD PC

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1700406618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSHUA M. IGNATOWICZ DMD PC

Provider Business Mailing Address
First Line	:	1070 W HORIZON RIDGE PKWY STE 121
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-6019
Country	:	US
Telephone Number	:	702-432-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1070 W HORIZON RIDGE PKWY STE 121
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-6019
Country	:	US
Telephone Number	:	702-432-9100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSHUA M IGNATOWICZ
Credential	:	DMD
Telephone Number	:	702-432-9100

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	04/21/2020

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