Provider Demographics
NPI:1659260305
Name:KOHLES, JOHNATHAN (DDS)
Entity type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:
Last Name:KOHLES
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 1:18745 BETHPAGE DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4859
Mailing Address - Country:US
Mailing Address - Phone:443-987-0941
Mailing Address - Fax:
Practice Address - Street 1:2280 HOGAN ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80913-4408
Practice Address - Country:US
Practice Address - Phone:719-526-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist