Martin H Telich, D.D.S.
Individual provider Active NPI General Practice Dentistry · Vermilion, OH
NPI 1093936767 · NPPES record last updated Aug 13, 2007
Key facts
- NPI
- 1093936767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 18293 (OH)
- Practice address
- 5433 Liberty Ave
Vermilion, OH 44089-1333 - Phone
- (440) 967-5277
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130109000287 | OH | Order and Referring Only - Oral Surgery |
8224281969 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18293 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telich and Ladopoulos, D.D.S., Inc. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18293 | OH | Yes |
Addresses
Primary practice location
5433 Liberty Ave
Vermilion, OH 44089-1333
Mailing address
5433 Liberty Ave
Vermilion, OH 44089-1333
Phone (440) 967-5277
Other providers in Vermilion, OH
- Ihor N. Suszko
- Jodie P Szivan
- Joseph Ryan Szivan
- Brandon Talbert
- Telich and Ladopoulos, D.D.S., Inc.
- Khin Zan Tha
- Elizabeth Marie Thaxton
- Therapy Unscripted LLC
- Sonja Thompson
- Tameka Thornton
All providers in Vermilion, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.