| Jonathan Nash, Dds Pc | |
|
2517 17th St Suite A Lewiston ID 83501-6311 | |
| (208) 746-1373 | |
| (208) 746-9855 |
| Full Name | Jonathan Nash, Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 2517 17th St, Lewiston, Idaho |
| Authorized Official Name and Position | Jonathan B Nash (OWNER) |
| Authorized Official Contact | 2087461373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Nash, Dds Pc 2517 17th St Lewiston ID 83501-6311 Ph: (208) 746-1373 | Jonathan Nash, Dds Pc 2517 17th St Suite A Lewiston ID 83501-6311 Ph: (208) 746-1373 |
| NPI Number | 1205006103 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 07/29/2024 |
| Medicare PECOS PAC ID | 2365975273 |
|---|---|
| Medicare Enrollment ID | O20241031000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205006103 | NPI | - | NPPES |
| 149960173 | Other | ID | ADA |
| 6A242 | Other | ID | BLUE CROSS |
| 805043900 | Medicaid | ID | |
| 000010011285 | Other | ID | REGENCE BLUE SHIELD |
| 1992813182 | Other | ID | NPI # INDIVIDUAL |
| 9201666 | Other | ID | IDAHO SMILES - DORAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3242 (Idaho) | Primary |
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