Individual
DR. JON ALAN PIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12268
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1ZZ68
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2489
WV
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS02201ZL
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136374000
—
WV
01
—
229044
TRIGOD
—
01
—
DF52
BCBS
MD
Enumeration date
11/08/2006
Last updated
11/02/2012
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