| Jonas A. Lichty Dds Md Pa | |
|
1919 N Webb Rd Wichita KS 67206-3405 | |
| (316) 634-1414 | |
| Not Available |
| Full Name | Jonas A. Lichty Dds Md Pa |
|---|---|
| Speciality | Dentist |
| Location | 1919 N Webb Rd, Wichita, Kansas |
| Authorized Official Name and Position | Jonas A Lichty (OWNER) |
| Authorized Official Contact | 3166341414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonas A. Lichty Dds Md Pa 1919 N Webb Rd Wichita KS 67206-3405 Ph: (316) 634-1414 | Jonas A. Lichty Dds Md Pa 1919 N Webb Rd Wichita KS 67206-3405 Ph: (316) 634-1414 |
| NPI Number | 1215346713 |
|---|---|
| Provider Enumeration Date | 08/08/2014 |
| Last Update Date | 08/08/2014 |
| Medicare PECOS PAC ID | 4981824240 |
|---|---|
| Medicare Enrollment ID | O20141008001929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215346713 | NPI | - | NPPES |
| 1891965224 | Medicaid | KS | |
| 1891965224 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Jonas A Lichty |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1891965224 PECOS PAC ID: 2860661162 Enrollment ID: I20110802000712 |
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