Provider Demographics
NPI:1083424311
Name:ZIMMERMAN FAMILY DENTISTRY, INC.
Entity type:Organization
Organization Name:ZIMMERMAN FAMILY DENTISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:LUKE
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:814-494-1135
Mailing Address - Street 1:114 W PENN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16662-1113
Mailing Address - Country:US
Mailing Address - Phone:814-793-4362
Mailing Address - Fax:814-793-4362
Practice Address - Street 1:114 W PENN ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:PA
Practice Address - Zip Code:16662-1113
Practice Address - Country:US
Practice Address - Phone:814-793-4362
Practice Address - Fax:814-793-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty