Active NPI
Anthony P Bastulli, DDS
- Endodontics
- Mayfield HTS, OH
National Provider Identifier
1053432849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 18192
- Practice address
- 6801 Mayfield Rd
#543
Mayfield HTS, OH 44124-2270 - Phone
- (440) 605-0456
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 18192 | OH | Primary |
Addresses
Primary practice location
6801 Mayfield Rd
#543
Mayfield HTS, OH 44124-2270
Mailing address
6801 Mayfield Rd
#543
Mayfield HTS, OH 44124-2270
Phone (440) 605-0456
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18192 | OH | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053432849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6801 MAYFIELD RD",
"address_2": "#543",
"city": "MAYFIELD HTS",
"state": "OH",
"postal_code": "441242270",
"telephone_number": "440-605-0456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 MAYFIELD RD",
"address_2": "#543",
"city": "MAYFIELD HTS",
"state": "OH",
"postal_code": "441242270",
"telephone_number": "440-605-0456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTULLI",
"first_name": "ANTHONY",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "OH",
"license": "18192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayfield HTS, 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.