Provider Demographics
NPI:1285897611
Name:RICHTSTEIG, JONATHAN D (DMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:D
Last Name:RICHTSTEIG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18550 S RITTENHOUSE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-4598
Mailing Address - Country:US
Mailing Address - Phone:480-840-3005
Mailing Address - Fax:480-840-6084
Practice Address - Street 1:18550 S RITTENHOUSE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-4598
Practice Address - Country:US
Practice Address - Phone:480-840-3005
Practice Address - Fax:480-840-6084
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD75681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice