Individual provider Active NPI

Suparna Argekar Mahalaha, DDS. MPH

  • Dentist
  • Cleveland, OH
National Provider Identifier
1033354485
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-022910 Issued in OH
Practice address
1530 Saint Clair Ave NE
Cleveland, OH 44114-2004
Phone
(216) 781-6228
Fax
(216) 298-5015
NPI assigned
Dec 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-022910 OH Primary

Addresses

Primary practice location

1530 Saint Clair Ave NE
Cleveland, OH 44114-2004

Mailing address

6500 Summit Cir
Brecksville, OH 44141-1838
Phone (440) 526-6215

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
I20171012002449 OH Order and Referring Only - DentistPractitioner - Dentist 3476788662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-022910OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistree, Inc. Dentist PastSince May 17, 2010 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": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1033354485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 SUMMIT CIR",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411838",
            "telephone_number": "440-526-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 SAINT CLAIR AVE NE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142004",
            "telephone_number": "216-781-6228",
            "fax_number": "216-298-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHALAHA",
        "first_name": "SUPARNA",
        "middle_name": "ARGEKAR",
        "name_prefix": "Dr.",
        "credential": "DDS. MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.