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General NPI Number Information
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NPI Number | 1659260305
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Entity Type | Individual
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Provider Name | JOHNATHAN KOHLES DDS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 2280 HOGAN ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80913-4408
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Country | US
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Telephone | 719-526-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 18745 BETHPAGE DR
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City | LEWES
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State | DE
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Zip | 19958-4859
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Country | US
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Telephone | 443-987-0941
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18639
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License Number State | MD
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