Provider Demographics
NPI:1639259930
Name:RHONEMUS, JEFFREY WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WILLIAM
Last Name:RHONEMUS
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 1:2519 E MAIN ST
Mailing Address - Street 2:STE 102
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-5864
Mailing Address - Country:US
Mailing Address - Phone:765-962-1519
Mailing Address - Fax:765-966-0081
Practice Address - Street 1:2519 E MAIN ST
Practice Address - Street 2:STE 102
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-5864
Practice Address - Country:US
Practice Address - Phone:765-962-1519
Practice Address - Fax:765-966-0081
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007652A122300000X
KY9267122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN12007652AOtherINDIANA LICENSE NUMBER
IN100235560AOtherPID
KY9267OtherKY LICENSE
IN100235560AOtherPID
KY9267OtherKY LICENSE