Active NPI
Emily Reusser, D.D.S.
- Dentist
- Canton, OH
National Provider Identifier
1114373016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.24704
- Practice address
- 2725 Lincoln St E
Canton, OH 44707-2769 - Phone
- (330) 454-2000
- NPI assigned
- May 10, 2016
- Last updated
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.24704 | OH | Primary |
Addresses
Primary practice location
2725 Lincoln St E
Canton, OH 44707-2769
Mailing address
2725 Lincoln St E
Canton, OH 44707-2769
Phone (330) 454-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0236783 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170725001474 | OH | Order and Referring Only - Dentist | 1456621465 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.24704 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1114373016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 LINCOLN ST E",
"city": "CANTON",
"state": "OH",
"postal_code": "447072769",
"telephone_number": "330-454-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 LINCOLN ST E",
"city": "CANTON",
"state": "OH",
"postal_code": "447072769",
"telephone_number": "330-454-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REUSSER",
"first_name": "EMILY",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-10",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.24704",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0236783",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.