P Praxis·MD
● Active Type 1 · Individual

DR. Jonathan Daniel Lane, DMD

Dentist·Fort Gordon, GA· NPI 1164779294 · Enumerated 2012 · 13 years on NPI
Lane is 1 of 5 dentist providers in Fort Gordon and 1 of 221 in Georgia.
NPI age
13 years
Enumerated 2012-08-08
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
PA
1 state
Status
Active
No deactivations on record
Last NPPES update
2016-07-26
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 221 active dentist providers in Georgia.

NPI age
13 years
↓ 6 yr below median (19 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
1
In the 23% of peers with subspecialties

NPI lifetime · 2012 → 2026

2012-08Enumerated in NPPES
2012 2026

Where they practice

Practice location
38717 38th Street, Dentac Credentials Office
Fort Gordon, GA 309055660
📞 7067876927fax 7067872082
Mailing address
Hq, 618th Dental Company (as), Unit #15652, Bldg S-5403
Apo, AP 962055652
📞 0118222600fax 3157372600

Specialties

  • Dentist Primary
    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...
    PA license #DS039289 taxonomy 1223P0300X
  • Dentist
    A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
    PA license #DS039289 taxonomy 122300000X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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