Provider Demographics
NPI:1013236819
Name:GENTHER, DANE JEFFERY (MD)
Entity Type:Individual
Prefix:DR
First Name:DANE
Middle Name:JEFFERY
Last Name:GENTHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:A71
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195
Mailing Address - Country:US
Mailing Address - Phone:216-445-3729
Mailing Address - Fax:216-445-9409
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:A71
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-445-3729
Practice Address - Fax:216-445-9409
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD181943207Y00000X
MDD74754207Y00000X
OH35.133967207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology