Dominik Berdysz, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

30-024174 Issued in OH

Practice address

500 Gypsy LN
Youngstown, OH 44504-1315

Phone

(330) 506-0987

NPI assigned

Jun 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dominik.berdysz.p11@direct.loraincountyhealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lorain County Health & Dentistry

  • Clinic/Center
  • Lorain, OH
  • NPI 1215194527
  Medicare reassignment NPD
• Lorain County Health & Dentistry

  • Clinic/Center
  • Elyria, OH
  • NPI 1336484559
  NPD
• Lorain County Health & Dentistry

  • Community/Retail Pharmacy
  • Lorain, OH
  • NPI 1871304550
  NPD

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1073927414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 OMALLEY DR",
            "address_2": "APT.203",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441347519",
            "telephone_number": "614-515-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "330-506-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDYSZ",
        "first_name": "DOMINIK",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-13",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigale L Benson, MSN, PMHNP-BC
• Charnitta Benson, CDCA
• Tyeisha Benson
• Earlyn R Bentfeld, R.D.
• Maureen Bentum
• Keith Berger
• Lauren Elizabeth Berger, LCDC II
• Katie Louise Bergin, LISW-S
• Theresa Berkenyi
• Michael J Bernard, CASE MANAGER

• Dentist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.