Individual provider Active NPI

Paul Vesoulis, DDS

  • General Practice Dentistry
  • Toledo, OH
National Provider Identifier
1073516050
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-01-8297 Issued in OH
Practice address
4611 N Summit St
Toledo, OH 43611-2812
Phone
(419) 729-3972
Fax
(419) 729-3938
NPI assigned
May 24, 2005
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
General Practice Dentistry 1223G0001X 30-01-8297 OH Primary

Addresses

Primary practice location

4611 N Summit St
Toledo, OH 43611-2812

Mailing address

4611 N Summit St
Toledo, OH 43611-2812
Phone (419) 729-3972

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
I20150519000506 OH Order and Referring Only - DentistPractitioner - Dentist 0941520720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Point Place Family Dentistry Paul Vesoulis DDS Past Accepting new patients
Point Place Dental Care PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 2

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073516050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436112812",
            "telephone_number": "419-729-3972",
            "fax_number": "419-729-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436112812",
            "telephone_number": "419-729-3972",
            "fax_number": "419-729-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESOULIS",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-8297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.