Provider Demographics
NPI:1649387937
Name:CASH, JOHN JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAY
Last Name:CASH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 SOUTH FOREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834
Mailing Address - Country:US
Mailing Address - Phone:812-448-8490
Mailing Address - Fax:812-446-4801
Practice Address - Street 1:924 SOUTH FOREST AVENUE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834
Practice Address - Country:US
Practice Address - Phone:812-448-8490
Practice Address - Fax:812-446-4801
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7589122300000X
FLDN 15117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist