MEDICARE: DR. JONATHAN FRANKLIN ROSENTHAL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19196-OH	OH

General Provider Information

NPI Number	:	1992756928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN FRANKLIN ROSENTHAL DDS

Provider Business Mailing Address
First Line	:	5216 CHILLICOTHE RD.
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022
Country	:	US
Telephone Number	:	440-338-8084
Fax Number	:	440-338-8085

Provider Business Practice Location Address
First Line	:	5216 CHILLICOTHE RD
Second Line	:
City	:	SOUTH RUSSELL
State	:	OH
Zip	:	44022-4335
Country	:	US
Telephone Number	:	440-338-8084
Fax Number	:	440-338-8085

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	03/21/2013

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