Provider Demographics
NPI:1306736780
Name:HOFFMAN, MYKENZIE JO (DMD)
Entity type:Individual
Prefix:
First Name:MYKENZIE
Middle Name:JO
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:YORK SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17372-9019
Mailing Address - Country:US
Mailing Address - Phone:717-386-4957
Mailing Address - Fax:
Practice Address - Street 1:220 CUMBERLAND PKWY STE 6
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5683
Practice Address - Country:US
Practice Address - Phone:717-386-4957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0452601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice