Individual provider Active NPI

Frank George Radis, DDS, MS

  • Pediatric Dentistry
  • Aurora, OH
National Provider Identifier
1043359391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30.019192 Issued in OH
Practice address
85 N Chillicothe Rd
Aurora, OH 44202-8739
Phone
(330) 562-2700
Fax
(330) 562-0534
NPI assigned
Feb 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Pediatric Dentistry 1223P0221X 30.019192 OH Primary

Addresses

Primary practice location

85 N Chillicothe Rd
Aurora, OH 44202-8739

Mailing address

85 N Chillicothe Rd
Aurora, OH 44202-8739
Phone (330) 562-2700

Other identifiers 1

IdentifierTypeStateIssuer
2050097MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30.019192OHMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Frank Radis, DDS, Ms, Inc Pediatric Dentistry 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043359391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 N CHILLICOTHE RD",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442028739",
            "telephone_number": "330-562-2700",
            "fax_number": "330-562-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 N CHILLICOTHE RD",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442028739",
            "telephone_number": "330-562-2700",
            "fax_number": "330-562-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADIS",
        "first_name": "FRANK",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.019192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2050097",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.