A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | General Practice | 1223G0001X |
| Prosthodontics | 1223P0700X |
* Indicates primary specialty
| NPI Number | 1104385541 |
| Credentials | DDS, MS |
| Entity | Individual |
| Enumeration date | 03/15/2019 |
| Last updated | 07/01/2025 - About 11 months ago |
| Sole proprietor1 | Yes |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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