Provider Demographics
NPI:1700425030
Name:THE FAMILY DENTIST OF WESTLAKE JONATHAN J KLINEMAN DDS INC
Entity Type:Organization
Organization Name:THE FAMILY DENTIST OF WESTLAKE JONATHAN J KLINEMAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-870-1657
Mailing Address - Street 1:26600 DETROIT RD SUITE 230
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:440-871-8588
Mailing Address - Fax:440-871-8355
Practice Address - Street 1:26600 DETROIT RD SUITE 230
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-871-8588
Practice Address - Fax:440-871-8355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty