Provider Demographics
NPI:1386764058
Name:JONATHAN J KLINEMAN DDS INC. FAMILY DENTISTRY
Entity type:Organization
Organization Name:JONATHAN J KLINEMAN DDS INC. FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-943-1117
Mailing Address - Street 1:27127 CHARDON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1115
Mailing Address - Country:US
Mailing Address - Phone:440-943-1117
Mailing Address - Fax:440-943-9513
Practice Address - Street 1:27127 CHARDON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1115
Practice Address - Country:US
Practice Address - Phone:440-943-1117
Practice Address - Fax:440-943-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty