Individual provider Active NPI

Dennis James Nolan, DDS

  • Dentist
  • Mogadore, OH
National Provider Identifier
1033205992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30016592 Issued in OH
Practice address
60 South Cleveland Ave
Mogadore, OH 44260-1442
Phone
(330) 628-2424
Fax
(330) 628-3533
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30016592 OH Primary

Addresses

Primary practice location

60 South Cleveland Ave
Mogadore, OH 44260-1442

Mailing address

60 South Cleveland Ave
Mogadore, OH 44260-1442
Phone (330) 628-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150507000736 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799004016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30016592OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mogadore Dental Group Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033205992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SOUTH CLEVELAND AVE",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442601442",
            "telephone_number": "330-628-2424",
            "fax_number": "330-628-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SOUTH CLEVELAND AVE",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442601442",
            "telephone_number": "330-628-2424",
            "fax_number": "330-628-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "DENNIS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mogadore, OH

Sources for this page

Verify at the official NPI Registry.