Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1457582371 Deactivated / Inactive NPI Male Practitioner

Dr. Jonathan D Mahan , DMD

Dentist • Paducah, KY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jonathan Mahan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 28, 2009
NPI Deactivation Date November 20, 2025
Total Practice Duration ~16 Years of Practice (2009 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Mahan, DMD was a registered Dentist practicing in Paducah, KY. Throughout an active medical career spanning 16 years, Dr. Mahan provided care at the practice location at 1836 BROADWAY ST until profile deactivation on 2025-11-20.

Practice Location & Contact Primary Location

Practice Address

1836 Broadway St

Paducah, KY 420012708

Telephone 2704420256
Fax 2704428730
Associated Practice Facility / Clinic
🏢 Bohle Family Dentistry, Psc Facility NPI 1003135534

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Paducah, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
16 Specialists

Practicing in Paducah, KY (1101 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License KY 8745

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 degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1407141807

Doctor of Dental Medicine

NPI 1851775910

Doctor of Dental Medicine

NPI 1861844649

Doctor of Dental Medicine

NPI 1922010974

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated November 20, 2025

Record deactivated on November 20, 2025

NPI Profile Active February 14, 2017

NPI status registered as active in NPPES database

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Updated Practice Location February 14, 2017

Registered at 148 EAST KENTUCKY DR,, LA CENTER, KY 42056 (Tel: 2706659557)

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Updated Business Mailing Address February 14, 2017

Registered at 148 E. KY DRIVE, P.O. BOX 540, LA CENTER, KY 420560540 (Tel: 2706659557)

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Provider Name / Credentials Updated February 14, 2017

Recorded as JONATHAN MAHAN, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 14, 2017

Dentist (License #8745 in KY)

NPI Profile Active July 28, 2009

NPI status registered as active in NPPES database

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Updated Practice Location July 28, 2009

Registered at 1836 BROADWAY ST, PADUCAH, KY 420012708 (Tel: 2704420256)

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Updated Business Mailing Address July 28, 2009

Registered at 1836 BROADWAY ST, PADUCAH, KY 420012708 (Tel: 2704420256)

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Provider Name / Credentials Updated July 28, 2009

Recorded as JONATHAN MAHAN, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2009

Dentist (License #8745 in KY)

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Initial NPI Registration & Enumeration July 28, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1457582371
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2009
Last Update: July 28, 2009
Deactivation Date: November 20, 2025

Mailing Address

1836 Broadway St

Paducah, KY 420012708

Phone: 2704420256

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.