NPIMap

Organization Active NPI

Ohio Dental Professionals, Delisle, P.C.

Doing business as Cabi Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Aurora, OH
National Provider Identifier
1063061703
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Doing business as
Cabi Family & Cosmetic Dentistry
Practice address
485 N Aurora Rd
Aurora, OH 44202-8721
Phone
(330) 562-1644
NPI assigned
Sep 5, 2019
Last updated
Sep 5, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

485 N Aurora Rd
Aurora, OH 44202-8721

Mailing address

485 N Aurora Rd
Aurora, OH 44202-8721
Phone (330) 562-1644

Other names 1

  • Cabi Family & Cosmetic Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Oh Richard E Workman DMD PS39 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Oh Richard E Workman DMD PS

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

485 N Aurora Rd
Aurora, OH 44202
Phone (330) 562-1644

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1063061703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 N AURORA RD",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442028721",
            "telephone_number": "330-562-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 N AURORA RD",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442028721",
            "telephone_number": "330-562-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cabi Family & Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 5, 2019; 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.