NPIMap

Organization Active NPI

Anew Medspa 2120 LLC

  • Dental Clinic/Center
  • South Euclid, OH
National Provider Identifier
1043601271
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
30.016769 Issued in OH
Legal business name
ANEW MEDSPA 2120 LLC
Practice address
2120 S Green Rd
South Euclid, OH 44121-3349
Phone
(216) 255-5201
NPI assigned
Feb 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Dr. Louis J Malcmacher, DDS
Title
Owner
Phone
(216) 255-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 30.016769 OH Primary

Addresses

Primary practice location

2120 S Green Rd
South Euclid, OH 44121-3349

Mailing address

2120 S Green Rd
South Euclid, OH 44121-3349
Phone (216) 255-5201

National Provider Directory

National Provider Directory

Locations

2120 S Green Rd
South Euclid, OH 44121
Phone (216) 255-5201

Practitioners & affiliated clinicians

Practitioners 2

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": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1043601271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 S GREEN RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213349",
            "telephone_number": "216-255-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 S GREEN RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213349",
            "telephone_number": "216-255-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANEW MEDSPA 2120 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "MALCMACHER",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-255-5201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "30.016769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.