Provider Demographics
NPI:1124662192
Name:DEAN, JONATHON MICHAEL (MB BCHIR MA (CANTAB))
Entity type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:MICHAEL
Last Name:DEAN
Suffix:
Gender:M
Credentials:MB BCHIR MA (CANTAB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4832 CAPE CORAL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7229
Mailing Address - Country:US
Mailing Address - Phone:914-815-5582
Mailing Address - Fax:
Practice Address - Street 1:4832 CAPE CORAL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7229
Practice Address - Country:US
Practice Address - Phone:914-815-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ7518208207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology