NPIMap

Organization Active NPI

Cosmetic & Family Dental Studios, LLC

  • General Practice Dentistry
  • Toledo, OH
National Provider Identifier
1124090097
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18842 Issued in OH
Legal business name
COSMETIC & FAMILY DENTAL STUDIOS, LLC
Practice address
36 S Byrne Rd
Toledo, OH 43615-6211
Phone
(419) 534-2479
Fax
(419) 534-3260
NPI assigned
Feb 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Abraham H Boadi, DMDNPI 1881790715
Title
President & Ceo
Phone
(419) 534-2479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 18842 OH Primary

Addresses

Primary practice location

36 S Byrne Rd
Toledo, OH 43615-6211

Mailing address

36 S Byrne Rd
Toledo, OH 43615-6211
Phone (419) 534-2479

Other identifiers 3

IdentifierTypeStateIssuer
0719486MedicaidOH
01541OtherOHPARAMOUNT ADVANTAGE
18842-436156211OtherOHDELTA DENTAL OH/MI

National Provider Directory

National Provider Directory

Locations

36 S Byrne Rd
Toledo, OH 43615
Phone (419) 534-2479

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124090097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436156211",
            "telephone_number": "419-534-2479",
            "fax_number": "419-534-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436156211",
            "telephone_number": "419-534-2479",
            "fax_number": "419-534-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC & FAMILY DENTAL STUDIOS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOADI",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "419-534-2479",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "18842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0719486",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT ADVANTAGE",
            "identifier": "01541",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OH/MI",
            "identifier": "18842-436156211",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.