Provider Demographics
NPI:1639499791
Name:SONES, JONATHAN MICHAEL (DMD)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:SONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 W RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-1947
Mailing Address - Country:US
Mailing Address - Phone:618-283-1760
Mailing Address - Fax:618-283-1657
Practice Address - Street 1:2219 W RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1947
Practice Address - Country:US
Practice Address - Phone:618-283-1760
Practice Address - Fax:618-283-1657
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190283421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice