NPIMap

Organization Active NPI

Streetsboro Dental

  • General Practice Dentistry
  • Streetsboro, OH
National Provider Identifier
1013386739
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.024612 Issued in OH
Legal business name
STREETSBORO DENTAL
Practice address
1727 Streetsboro PLZ
Streetsboro, OH 44241-5635
Phone
(330) 626-3814
NPI assigned
Sep 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey Mark Danczak, D.M.D.NPI 1487025938
Title
Associate Dentist
Phone
(216) 280-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30.024612 OH Primary

Addresses

Primary practice location

1727 Streetsboro PLZ
Streetsboro, OH 44241-5635

Mailing address

1727 Streetsboro PLZ
Streetsboro, OH 44241-5635
Phone (330) 626-3814

National Provider Directory

National Provider Directory
Tax ID family
Streetsboro Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1727 Streetsboro Plz
Streetsboro, OH 44241
Phone (330) 626-3814

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1013386739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 STREETSBORO PLZ",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415635",
            "telephone_number": "330-626-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 STREETSBORO PLZ",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415635",
            "telephone_number": "330-626-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREETSBORO DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "DANCZAK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "ASSOCIATE DENTIST",
        "authorized_official_telephone_number": "216-280-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.