Jonathan R Draper, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55059 Issued in CA

Practice address

629 Camino de Los Mares
Suite 102
San Clemente, CA 92673-2834

Phone

(949) 248-5555

NPI assigned

Jan 12, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1447497524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES",
            "address_2": "SUITE 102",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732834",
            "telephone_number": "949-248-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES",
            "address_2": "SUITE 102",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732834",
            "telephone_number": "949-248-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAPER",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doula Vine
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• Dr. Alice P. Moran, DMD, Apc
• Larry Mark Drechsler, PHARM.D.
• Dual Diagnosis Treatment Center, Inc. (Sovereign By The Sea I)
• Erin Kathleen Duffy
• Aubrey Duskin
• Alicia Marie Duzman, PHD

• General Practice Dentistry in San Clemente, CA
• Providers in San Clemente, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.