Individual provider Active NPI

Rebecca Mintz-Gecovich, D.D.S.

  • Dentist
  • Parma, OH
National Provider Identifier
1043376445
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21967 Issued in OH
Practice address
6789 Ridge Rd
Suite 306
Parma, OH 44129-5649
Phone
(440) 845-6420
Fax
(440) 845-6427
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21967 OH Primary

Addresses

Primary practice location

6789 Ridge Rd
Suite 306
Parma, OH 44129-5649

Mailing address

6789 Ridge Rd
Suite 306
Parma, OH 44129-5649
Phone (440) 845-6420

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
I20170106000708 OH Order and Referring Only - DentistPractitioner - Dentist 7416238431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21967OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1043376445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6789 RIDGE RD",
            "address_2": "SUITE 306",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295649",
            "telephone_number": "440-845-6420",
            "fax_number": "440-845-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6789 RIDGE RD",
            "address_2": "SUITE 306",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295649",
            "telephone_number": "440-845-6420",
            "fax_number": "440-845-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ-GECOVICH",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "21967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.