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DR. JONATHAN DANIEL LANE DMD
NPI 1164779294
Dentist - Periodontics in Fort Gordon, GA

Active since August 08, 2012
38717 38TH STREET, DENTAC CREDENTIALS OFFICE, FORT GORDON, GA 30905(706) 787-6927(706) 787-2082 Get Directions Write a Review

NPPES record last updated: July 26, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jonathan Daniel Lane Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN DANIEL LANE DMD (NPI 1164779294) is an individual periodontics provider in Fort Gordon, Georgia, licensed in Pennsylvania (DS039289) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1164779294
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. JONATHAN DANIEL LANECredential: DMD
Location Address38717 38TH STREET, DENTAC CREDENTIALS OFFICEFort Gordon, GA 30905-5660
Mailing AddressHq, 618th Dental Company (as), Unit #15652, Bldg S-5403Apo, AP 96205-5652 · (011) 822-2600 · Fax (315) 737-2600
Phone(706) 787-6927
Fax(706) 787-2082
Sole ProprietorNo
Enumeration DateAugust 8, 2012
Last NPPES UpdateJuly 26, 2016
✔ NPI 1164779294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in PA · DS039289
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Also ListedDentistTaxonomy 122300000X · License DS039289 (PA)
38717 38TH STREET, Fort Gordon, GA 30905
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSHUA DANIEL JONES
Dentist (Endodontics)
38717 38TH STREET, US ARMY DENTAL HEALTH ACTIVITY
FT. GORDON, GA 30905
Richmond County (706) 787-6927
SUZANNE HOLLINGSWORTH DDS
Dentist
38717 38TH STREET, USA DENTAC
FT GORDON, GA 30905
Richmond County (706) 787-7050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Lane's NPI number?

The NPI number for Jonathan Lane is 1164779294. It was assigned to this individual provider in the NPPES registry on August 8, 2012.

Where is Jonathan Lane located?

Jonathan Lane practices at 38717 38th Street Dentac Credentials Office, Fort Gordon, GA 30905. The listed phone number is (706) 787-6927.

What is Jonathan Lane's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Jonathan Lane was last updated on July 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.