Provider Demographics
NPI:1033405816
Name:DRANEY, JONATHAN W (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:W
Last Name:DRANEY
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 1:1678 JUPITER AVE
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9572
Mailing Address - Country:US
Mailing Address - Phone:435-724-1575
Mailing Address - Fax:
Practice Address - Street 1:121 E 6TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2595
Practice Address - Country:US
Practice Address - Phone:740-475-0700
Practice Address - Fax:740-475-0703
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.30701223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0081621Medicaid