Provider Demographics
NPI:1578122677
Name:JONATHAN RUNION DDS LLC
Entity Type:Organization
Organization Name:JONATHAN RUNION DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:RUNION
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-775-1300
Mailing Address - Street 1:1110 BEECHER XING N STE A
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4564
Mailing Address - Country:US
Mailing Address - Phone:614-775-1300
Mailing Address - Fax:
Practice Address - Street 1:3775 TRUEMAN CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-2496
Practice Address - Country:US
Practice Address - Phone:614-775-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1730491630OtherINDIVIDUAL NPI
OH1730546235OtherINDIVIDUAL NPI