Provider Demographics
NPI:1669634275
Name:SWANSON, JOSHUA L (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:L
Last Name:SWANSON
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 1:5100 SOUTHPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2661
Mailing Address - Country:US
Mailing Address - Phone:540-710-1088
Mailing Address - Fax:540-710-1109
Practice Address - Street 1:5100 SOUTHPOINT PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2661
Practice Address - Country:US
Practice Address - Phone:540-710-1088
Practice Address - Fax:540-710-1109
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice