Individual provider Active NPI

Francis Andrew Bertolini, DDS

  • General Practice Dentistry
  • North Canton, OH
National Provider Identifier
1114034220
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15393 Issued in OH
Practice address
6500 Whipple Ave NW
North Canton, OH 44720-7340
Phone
(330) 494-6305
Fax
(330) 494-7311
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

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 15393 OH Primary

Addresses

Primary practice location

6500 Whipple Ave NW
North Canton, OH 44720-7340

Mailing address

6500 Whipple Ave NW
North Canton, OH 44720-7340
Phone (330) 494-6305

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
I20160224001467 OH Order and Referring Only - DentistPractitioner - Dentist 1850696121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15393OHMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114034220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207340",
            "telephone_number": "330-494-6305",
            "fax_number": "330-494-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207340",
            "telephone_number": "330-494-6305",
            "fax_number": "330-494-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLINI",
        "first_name": "FRANCIS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "15393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.