Jan M. Bohonek, D.D.S.

Individual provider Active NPI General Practice Dentistry · Strongsville, OH

NPI 1972736346 · NPPES record last updated Sep 1, 2009

Key facts

NPI
1972736346
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
30.018311 (OH)
Practice address
11351 Pearl Rd
Suite 302
Strongsville, OH 44136-3331
Phone
(440) 846-8833
Fax
(440) 846-8920
NPI assigned
Sep 1, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
30.018311OHMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.018311 OH Yes

Addresses

Primary practice location

11351 Pearl Rd
Suite 302
Strongsville, OH 44136-3331

Mailing address

11351 Pearl Rd
Suite 302
Strongsville, OH 44136-3331
Phone (440) 846-8833

Other identifiers

IdentifierTypeStateIssuer
OHIO 18311OtherOHOHIO (SHORT VERSION OF OHIO DENTAL LICENSE NUMBER)

Other providers in Strongsville, OH

All providers in Strongsville, OH · General Practice Dentistry in Ohio

Sources for this page

Verify at the official NPI Registry.